2024
Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study. Journal Of Palliative Medicine 2024 PMID: 39515377, DOI: 10.1089/jpm.2024.0182.Peer-Reviewed Original ResearchSpecialist palliative careVeterans Affairs Medical CenterEnd of lifeCare qualityInpatient hospiceEnd of life outcomesUse of hospiceInpatient hospice careMedical CenterMultilevel logistic regressionFamilies of patientsAffairs Medical CenterHospice carePalliative careRetrospective cohort studyAdvanced heart failureBlack adultsHospiceCohort studyFacility rateLogistic regressionStudy outcomesObservational studyCareHeart failureFactors Associated With Influenza Vaccination in a National Veteran Cohort
Chen A, Farmer M, Han L, Runels T, Bade B, Crothers K, Bastian L, Bazan I, Bean-Mayberry B, Brandt C, Akgün K. Factors Associated With Influenza Vaccination in a National Veteran Cohort. AJPM Focus 2024, 4: 100290. PMID: 39611140, PMCID: PMC11602634, DOI: 10.1016/j.focus.2024.100290.Peer-Reviewed Original ResearchOdds of vaccinationInfluenza vaccineFemale veteransAmerican Indian/Alaskan Native raceFactors associated with influenza vaccinationReceipt of influenza vaccinationDocumenting influenza vaccinationReduced oddsRetrospective cohort studyElectronic health record dataMale veteransHealth record dataAmbulatory care utilizationInfluenza seasonRuralMale sexWhite male veteransWhite veteransAssociated with raceCohort studyBlack veteransBlack raceEthnic groupsRacial disparitiesInfluenzaVariation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers
Zhan Y, Han L, Abel E, Akgun K, Redeker N, Feder S. Variation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers. Journal Of Pain And Symptom Management 2024, 67: e551-e552. DOI: 10.1016/j.jpainsymman.2024.02.339.Peer-Reviewed Original ResearchSpecialist palliative careVA Medical CenterDepartment of Veterans AffairsPalliative careVeterans AffairsRandom intercept multilevel logistic regressionPalliative care deliveryDelivery characteristicsMedical CenterMultilevel logistic regressionCare deliveryICD-9/10 codesAdvanced heart failureRetrospective cohort studyHealth careModifiable factorsCareTeam staffingCohort studyHeart failureLogistic regressionImplementation effortsIdentified factorsICD-9/10Study findingsVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10
2023
Incidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty
Weinstein E, Stephens-Shields A, Newcomb C, Silibovsky R, Nelson C, O’Donnell J, Glaser L, Hsieh E, Hanberg J, Tate J, Akgün K, King J, Re V. Incidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty. JAMA Network Open 2023, 6: e2340457. PMID: 37906194, PMCID: PMC10618849, DOI: 10.1001/jamanetworkopen.2023.40457.Peer-Reviewed Original ResearchConceptsPrimary total knee arthroplastyProsthetic joint infectionTotal knee arthroplastyIncidence rate ratiosLate prosthetic joint infectionsPostoperative periodIncidence rateCohort studyOverall cohortJoint infectionKnee arthroplastyVeterans Affairs Surgical Quality Improvement Program dataElective primary total knee arthroplastyEarly prosthetic joint infectionHepatitis C virus infectionQuality Improvement Program dataVeterans Affairs Corporate Data WarehouseAutoimmune inflammatory arthritisPostoperative antibiotic useC virus infectionRisk factor modificationChronic kidney diseasePeripheral artery diseaseLate postoperative periodYears of careAdvance directive screening among veterans with incident heart failure: Comparisons among people aging with and without HIV
Walenczyk K, Cavanagh C, Skanderson M, Feder S, Soliman A, Justice A, Burg M, Akgün K. Advance directive screening among veterans with incident heart failure: Comparisons among people aging with and without HIV. Heart & Lung 2023, 61: 1-7. PMID: 37023581, PMCID: PMC10524135, DOI: 10.1016/j.hrtlng.2023.03.018.Peer-Reviewed Original ResearchConceptsIncident heart failureVeterans Aging Cohort StudyHeart failureAD screeningDisease severityCox proportional hazards regressionIncident HF diagnosisAging Cohort StudyProportional hazards regressionGreater disease severityAdvance directive completionAssociation of ADFuture quality improvementCare contactsCohort studyHF diagnosisHIV statusScreening ratesHazards regressionPoor prognosisDiagnosis codesCardiology subspecialtiesHaenszel testHealthcare encountersPWHRacial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates
Bernstein E, DeRycke E, Han L, Farmer M, Bastian L, Bean-Mayberry B, Bade B, Brandt C, Crothers K, Skanderson M, Ruser C, Spelman J, Bazan I, Justice A, Rentsch C, Akgün K. Racial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates. AJPM Focus 2023, 2: 100094. PMID: 37362395, PMCID: PMC10038675, DOI: 10.1016/j.focus.2023.100094.Peer-Reviewed Original ResearchRace/ethnicity groupsFirst vaccinationFirst COVID-19 vaccinationVeterans AffairsWhite veteransCharlson Comorbidity IndexRetrospective cohort studyPrimary care visitsEthnicity groupsCOVID-19 vaccinationLarge healthcare systemEquitable vaccine distributionAsian Americans/Pacific IslandersRace/ethnicityUnvaccinated patientsComorbidity indexInfluenza vaccinationSelf-reported categoriesBlack groupCare visitsCohort studyHazard ratioPrimary outcomeWhite patientsBlack patients
2020
Incidence and Presentation of Sarcoidosis With and Without HIV Infection
Hanberg JS, Akgün K, Hsieh E, Fraenkel L, Justice A. Incidence and Presentation of Sarcoidosis With and Without HIV Infection. Open Forum Infectious Diseases 2020, 7: ofaa441. PMID: 33123611, PMCID: PMC7576681, DOI: 10.1093/ofid/ofaa441.Peer-Reviewed Original ResearchVeterans Aging Cohort StudyIncident sarcoidosisCD4 countCohort studyMedian CD4 countPresentation of sarcoidosisHIV-negative controlsAging Cohort StudyDiagnosis of sarcoidosisDevelopment of sarcoidosisHIV-1 RNAProspective observational analysisTreatment of sarcoidosisLongitudinal cohort studyIncidence of sarcoidosisRisk of sarcoidosisOral glucocorticoidsUninfected veteransUnsuppressed viremiaChart reviewOrgan involvementHIV infectionPersistent viremiaViral loadCase report
2017
The Differential Impact of Emphysema on Respiratory Symptoms and 6-Minute Walk Distance in HIV Infection
Triplette M, Attia E, Akgün K, Campo M, Rodriguez-Barradas M, Pipavath S, Shahrir S, Wongtrakool C, Goetz M, Kim J, Soo Hoo G, Brown ST, Crothers K. The Differential Impact of Emphysema on Respiratory Symptoms and 6-Minute Walk Distance in HIV Infection. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2017, 74: e23-e29. PMID: 27716727, PMCID: PMC5140705, DOI: 10.1097/qai.0000000000001133.Peer-Reviewed Original ResearchConceptsHIV subjectsChronic coughRespiratory symptomsAirflow obstructionWalk distanceRadiographic emphysemaAssociation of emphysemaHIV uninfected subjectsPulmonary function testingCross-sectional analysisPulmonary symptomsCohort studyHIV infectionHIV statusFunction testingClinical impactEmphysemaEmphysema severitySmoking behaviorMild formSymptomsCoughGreater burdenPhlegmHealth effects
2015
Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Barakat LA, Juthani-Mehta M, Allore H, Trentalange M, Tate J, Rimland D, Pisani M, Akgün KM, Goetz MB, Butt AA, Rodriguez-Barradas M, Duggal M, Crothers K, Justice AC, Quagliarello VJ. Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia. HIV Medicine 2015, 16: 421-430. PMID: 25959543, PMCID: PMC5015437, DOI: 10.1111/hiv.12244.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaVeterans Aging Cohort StudyVACS IndexCAP outcomesAntiretroviral therapyOlder adultsHigher VACS indexDays of dischargeAging Cohort StudyUninfected participantsCohort studyMean LOSHIV infectionLonger LOSClinical outcomesUnadjusted analysesUninfected groupMultivariable modelEligibility criteriaHIVMale veteransMortality rateART useMortalityOutcomes