2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2002
Thrombolysis for Acute Stroke in Routine Clinical Practice
Bravata DM, Kim N, Concato J, Krumholz HM, Brass LM. Thrombolysis for Acute Stroke in Routine Clinical Practice. JAMA Internal Medicine 2002, 162: 1994-2001. PMID: 12230423, DOI: 10.1001/archinte.162.17.1994.Peer-Reviewed Original ResearchConceptsMajor protocol deviationsRoutine clinical practiceConnecticut cohortProtocol deviationsHospital mortalityAcute strokeThrombolytic therapyClinical practiceExtracranial hemorrhageCommunity-based patientsMinor protocol deviationsHigh rateIntravenous thrombolysisAdverse eventsRetrospective cohortHemorrhage ratePatient outcomesConnecticut hospitalsPatientsThrombolysisNeurological disordersCohortExperienced cliniciansStudy settingTherapy
2001
Quality of care among elderly patients hospitalized with unstable angina
Shahi C, Rathore S, Wang Y, Thakur R, Wu W, Lewis J, Petrillo M, Radford M, Krumholz H. Quality of care among elderly patients hospitalized with unstable angina. American Heart Journal 2001, 142: 263-270. PMID: 11479465, DOI: 10.1067/mhj.2001.116477.Peer-Reviewed Original ResearchConceptsQuality of careMinutes of admissionUnstable anginaHealth care policyElderly patientsTherapeutic anticoagulationIntravenous heparinElectrocardiographic examinationCare policyPrescription of aspirinUse of aspirinHalf of patientsEligible patientsRisk stratificationConnecticut hospitalsElderly MedicareAnginaPatientsTherapeutic contraindicationsTherapeutic interventionsAspirinAdmissionHospitalCareAnticoagulationPredictors of costs of caring for elderly patients discharged with heart failure
Wexler D, Chen J, Smith G, Radford M, Yaari S, Bradford W, Krumholz H. Predictors of costs of caring for elderly patients discharged with heart failure. American Heart Journal 2001, 142: 350-357. PMID: 11479477, DOI: 10.1067/mhj.2001.116476.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overConnecticutFemaleHealth Services for the AgedHeart FailureHospital CostsHumansLength of StayMaleMedical RecordsMedicareModels, EconomicOutcome Assessment, Health CarePatient DischargePatient ReadmissionPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsConceptsHeart failureIndependent correlatesHeart failure-related admissionsHeart failure-related readmissionsSubstantial hospital costsHeart failure admissionsHistory of strokeSubset of patientsPrincipal discharge diagnosisSignificant independent correlatesOutcomes 6 monthsPredictors of costsMedicare administrative databasesCause readmissionClinical characteristicsElderly patientsAverage admissionDischarge diagnosisKidney failureCause costsCorrelates of costsMedical recordsRisk factorsAdministrative databasesConnecticut hospitalsAngiotensin-converting enzyme inhibitor dosages in elderly patients with heart failure
Chen Y, Wang Y, Radford M, Krumholz H. Angiotensin-converting enzyme inhibitor dosages in elderly patients with heart failure. American Heart Journal 2001, 141: 410-417. PMID: 11231438, DOI: 10.1067/mhj.2001.113227.Peer-Reviewed Original ResearchConceptsACE inhibitorsHeart failureClinical trialsSystolic dysfunctionElderly patientsLow dosesConfirmed heart failureDosage of angiotensinRepresentative elderly cohortDose-response relationshipHospital dischargeClinical factorsGuideline recommendationsElderly cohortMedication dataMedical recordsAdministrative databasesConnecticut hospitalsPractice guidelinesEnzyme inhibitorsPatientsLower mortalityHigh dosesDosesMortalityAspirin and the Treatment of Heart Failure in the Elderly
Krumholz HM, Chen YT, Radford MJ. Aspirin and the Treatment of Heart Failure in the Elderly. JAMA Internal Medicine 2001, 161: 577-582. PMID: 11252118, DOI: 10.1001/archinte.161.4.577.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseHeart failureArtery diseaseBenefits of aspirinPatients 65 yearsRetrospective cohort studyUse of aspirinGroup of patientsAspirin prescriptionAspirin therapyCohort studyDischarge medicationsOlder patientsPatient characteristicsRandomized trialsVascular diseaseTreatment characteristicsConnecticut hospitalsBaseline differencesAspirinPatientsLower mortalityStrong associationDiseaseStudy sample
2000
Predictors of readmission among elderly survivors of admission with heart failure
Krumholz H, Chen Y, Wang Y, Vaccarino V, Radford M, Horwitz R. Predictors of readmission among elderly survivors of admission with heart failure. American Heart Journal 2000, 139: 72-77. PMID: 10618565, DOI: 10.1016/s0002-8703(00)90311-9.Peer-Reviewed Original ResearchConceptsHigh-risk patientsHeart failureRisk predictorsCause readmissionClinical factorsValidation cohortHeart failure-related readmissionsPrior heart failurePatients 65 yearsPredictors of readmissionRisk of readmissionMedical record reviewGroup of patientsPrincipal discharge diagnosisResource-intensive interventionsMedicare administrative databasesCreatinine levelsElderly patientsPrior admissionReadmission ratesDerivation cohortRecord reviewDischarge diagnosisAdministrative databasesConnecticut hospitals
1999
Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.
Holmboe E, Meehan T, Radford M, Wang Y, Marciniak T, Krumholz H. Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The American Journal Of Medicine 1999, 107: 324-331. PMID: 10527033, DOI: 10.1016/s0002-9343(99)00239-9.Peer-Reviewed Original ResearchConceptsLength of stayEvidence-based medical therapyProportion of patientsMyocardial infarctionMedical therapyMedicare patientsMain endpointCritical pathwaysAngiotensin-converting enzyme inhibitorAcute myocardial infarctionCare of patientsLongitudinal cohort studyProcess of careFirst dayQuality of careCross-sectional analysisReperfusion therapyCohort studyPrincipal diagnosisConnecticut hospitalsPatientsEnzyme inhibitorsYale University SchoolStayClinical Scholars Program
1998
Sex Differences in Mortality After Myocardial Infarction: Evidence for a Sex-Age Interaction
Vaccarino V, Horwitz RI, Meehan TP, Petrillo MK, Radford MJ, Krumholz HM. Sex Differences in Mortality After Myocardial Infarction: Evidence for a Sex-Age Interaction. JAMA Internal Medicine 1998, 158: 2054-2062. PMID: 9778206, DOI: 10.1001/archinte.158.18.2054.Peer-Reviewed Original ResearchConceptsMyocardial infarctionMortality rateAge groupsSex-age interactionOlder womenHigh mortalityHigher hospital mortality rateSex differencesAge group 75 yearsHospital mortality rateRetrospective cohort studyProcess of careYounger age groupsSame age groupHospital deathOlder patientsCohort studyConsecutive patientsPatient ageComorbid conditionsHospital characteristicsClinical severityMedical recordsConnecticut hospitalsHigher oddsTrends in the Quality of Care for Medicare Beneficiaries Admitted to the Hospital With Unstable Angina
Krumholz H, Philbin D, Wang Y, Vaccarino V, Murillo J, Therrien M, Williams J, Radford M. Trends in the Quality of Care for Medicare Beneficiaries Admitted to the Hospital With Unstable Angina. Journal Of The American College Of Cardiology 1998, 31: 957-963. PMID: 9561993, DOI: 10.1016/s0735-1097(98)00106-5.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngina, UnstableAnticoagulantsAspirinConnecticutFemaleGuideline AdherenceHeparinHospitalsHumansMaleMedicarePlatelet Aggregation InhibitorsPractice Guidelines as TopicQuality Indicators, Health CareQuality of Health CareRetrospective StudiesSurvival AnalysisUnited StatesConceptsUse of aspirinUnstable anginaElderly patientsConsecutive patientsHospital admissionRetrospective cohort studyPrincipal discharge diagnosisPatterns of treatmentCare of patientsGuideline-based useQuality of careHealth care policyAHCPR guidelinesChest painHospital dischargeCohort studyMedical chartsPatient factorsDischarge diagnosisPatient outcomesPractice patternsConnecticut hospitalsPractice guidelinesAnginaMedicare beneficiaries
1995
Readmission rates, 30 days and 365 days postdischarge, among the 20 most frequent DRG groups, Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.
Hennen J, Krumholz HM, Radford MJ, Meehan TP. Readmission rates, 30 days and 365 days postdischarge, among the 20 most frequent DRG groups, Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993. Connecticut Medicine 1995, 59: 263-70. PMID: 7600797.Peer-Reviewed Original ResearchConceptsCrude readmission ratesReadmission ratesDRG categoriesConnecticut acute care hospitalsAge 65Three-year study periodStudy periodElderly Medicare beneficiariesAcute care hospitalsInpatients age 65Days postdischargeFiscal year 1991Inpatient admissionsInpatients ageConnecticut hospitalsAge 75Medicare beneficiariesAge groupsDRG groupsSignificant decreaseHospitalCorresponding ratesAgeFY 1993YearsMortality experience, 30-days and 365-days after admission, for the 20 most frequent DRG groups among Medicare inpatients aged 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.
Hennen J, Krumholz HM, Radford MJ. Mortality experience, 30-days and 365-days after admission, for the 20 most frequent DRG groups among Medicare inpatients aged 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993. Connecticut Medicine 1995, 59: 137-42. PMID: 7729135.Peer-Reviewed Original ResearchConceptsCrude mortality rateMortality rateDRG categoriesFiscal year 1991Medicare inpatientConnecticut acute care hospitalsThree-year study periodStudy periodElderly Medicare beneficiariesAcute care hospitalsInpatient admissionsConnecticut hospitalsAge 75Medicare beneficiariesFiscal year 1993Age 65Age groupsMortality experienceDRG groupsYears 1991AdmissionInpatientsHospitalMortality differentialsThree-year periodTwenty most frequent DRG groups among Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.
Hennen J, Krumholz HM, Radford MJ. Twenty most frequent DRG groups among Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993. Connecticut Medicine 1995, 59: 11-5. PMID: 7859443.Peer-Reviewed Original ResearchConceptsDRG categoriesConnecticut acute care hospitalsElderly Medicare beneficiariesElderly Medicare patientsAge group 65Acute care hospitalsInpatients age 65Care hospitalFiscal year 1991Inpatient admissionsInpatients ageConnecticut hospitalsGroup 65Medicare patientsAge subgroupsMedicare beneficiariesThree-year study periodAge 65Study periodDRG groupsNumber of dischargesMedicare dischargesHospitalYear periodYears