2022
Polypharmacy and medical intensive care unit (MICU) admission and 10-year all-cause mortality risk among hospitalized patients with and without HIV
Gordon KS, Crothers K, Butt AA, Edelman EJ, Gibert C, Pisani MM, Rodriguez-Barradas M, Wyatt C, Justice AC, Akgün KM. Polypharmacy and medical intensive care unit (MICU) admission and 10-year all-cause mortality risk among hospitalized patients with and without HIV. PLOS ONE 2022, 17: e0276769. PMID: 36302039, PMCID: PMC9612570, DOI: 10.1371/journal.pone.0276769.Peer-Reviewed Original ResearchMeSH KeywordsHIV InfectionsHospitalizationHumansIntensive Care UnitsPolypharmacyRetrospective StudiesConceptsMedical intensive care unit admissionIntensive care unit admissionCare unit admissionMICU admissionSeverity of illnessHazard ratioHIV statusUnit admissionCause mortalityHospitalized patientsElectronic health record cohortLevel of polypharmacyRetrospective cohort studyCause mortality riskCohort studyHIV infectionCox regressionPolypharmacyMortality riskFiscal year 2009AdmissionPatientsMortalitySubstance useStrong association
2021
Dexamethasone in hospitalised COVID-19 patients not on intensive respiratory support
Crothers K, DeFaccio R, Tate J, Alba PR, Goetz MB, Jones B, King JT, Marconi V, Ohl ME, Rentsch CT, Rodriguez-Barradas MC, Shahrir S, Justice AC, Akgün KM, Group F. Dexamethasone in hospitalised COVID-19 patients not on intensive respiratory support. European Respiratory Journal 2021, 60: 2102532. PMID: 34824060, PMCID: PMC8841623, DOI: 10.1183/13993003.02532-2021.Peer-Reviewed Original ResearchConceptsIntensive respiratory supportHospitalised COVID-19 patientsCOVID-19 patientsNasal cannulaEarly dexamethasoneRespiratory supportSevere acute respiratory syndrome coronavirus 2Low-flow nasal cannulaAcute respiratory syndrome coronavirus 2Coronavirus disease 2019 (COVID-19) patientsRespiratory syndrome coronavirus 2Cox proportional hazards modelUS Veterans Affairs hospitalsSyndrome coronavirus 2Veterans Affairs hospitalProportional hazards modelCOVID-19Prior corticosteroidsCause mortalityMortality benefitTotal patientsCoronavirus 2Unexposed groupReal-world findingsEarly initiationPolypharmacy-associated risk of hospitalisation among people ageing with and without HIV: an observational study
Justice AC, Gordon KS, Romero J, Edelman EJ, Garcia BJ, Jones P, Khoo S, Re V, Rentsch CT, Tate JP, Tseng A, Womack J, Jacobson D. Polypharmacy-associated risk of hospitalisation among people ageing with and without HIV: an observational study. The Lancet Healthy Longevity 2021, 2: e639-e650. PMID: 34870254, PMCID: PMC8639138, DOI: 10.1016/s2666-7568(21)00206-3.Peer-Reviewed Original ResearchMeSH KeywordsAgingCohort StudiesFemaleFrailtyHIV InfectionsHIV SeropositivityHospitalizationHumansMalePolypharmacyConceptsVeterans Aging Cohort StudyMedication countDrug-drug interactionsAntiretroviral therapyObservational studyPhysiological frailtyVeterans Affairs Health Services ResearchMore drug-drug interactionsRisk of hospitalisationRisk of admissionAging Cohort StudyHIV-1 RNANon-ART medicationsAdverse health outcomesNational InstituteHealth services researchAdditional medicationObserved medicationActive medicationCause mortalityMore medicationsCohort studyPrescription fillsHIV statusPrescription medicationsPharmacoepidemiology, Machine Learning, and COVID-19: An Intent-to-Treat Analysis of Hydroxychloroquine, With or Without Azithromycin, and COVID-19 Outcomes Among Hospitalized US Veterans
Gerlovin H, Posner DC, Ho YL, Rentsch CT, Tate JP, King JT, Kurgansky KE, Danciu I, Costa L, Linares FA, Goethert ID, Jacobson DA, Freiberg MS, Begoli E, Muralidhar S, Ramoni RB, Tourassi G, Gaziano JM, Justice AC, Gagnon DR, Cho K. Pharmacoepidemiology, Machine Learning, and COVID-19: An Intent-to-Treat Analysis of Hydroxychloroquine, With or Without Azithromycin, and COVID-19 Outcomes Among Hospitalized US Veterans. American Journal Of Epidemiology 2021, 190: 2405-2419. PMID: 34165150, PMCID: PMC8384407, DOI: 10.1093/aje/kwab183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnti-Bacterial AgentsAzithromycinCOVID-19COVID-19 Drug TreatmentDrug Therapy, CombinationFemaleHospitalizationHumansHydroxychloroquineIntention to Treat AnalysisMachine LearningMaleMiddle AgedPharmacoepidemiologyRetrospective StudiesSARS-CoV-2Treatment OutcomeUnited StatesVeteransConceptsUS veteransCOVID-19Veterans Affairs Health Care SystemRecent randomized clinical trialsAdministration of hydroxychloroquineEffectiveness of hydroxychloroquineRisk of intubationEffect of hydroxychloroquineElectronic health record dataRandomized clinical trialsTreatment of patientsUS veteran populationCOVID-19 outcomesCoronavirus disease 2019Health record dataRigorous study designsHealth care systemSurvival benefitTreat analysisEarly therapyHospitalized populationClinical trialsObservational studyDisease 2019HydroxychloroquineCOVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients
Stewart M, Rodriguez-Watson C, Albayrak A, Asubonteng J, Belli A, Brown T, Cho K, Das R, Eldridge E, Gatto N, Gelman A, Gerlovin H, Goldberg SL, Hansen E, Hirsch J, Ho YL, Ip A, Izano M, Jones J, Justice AC, Klesh R, Kuranz S, Lam C, Mao Q, Mataraso S, Mera R, Posner DC, Rassen JA, Siefkas A, Schrag A, Tourassi G, Weckstein A, Wolf F, Bhat A, Winckler S, Sigal EV, Allen J. COVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients. PLOS ONE 2021, 16: e0248128. PMID: 33730088, PMCID: PMC7968637, DOI: 10.1371/journal.pone.0248128.Peer-Reviewed Original ResearchConceptsHospitalized COVID-19 patientsCOVID-19 patientsUse of hydroxychloroquineElectronic health recordsAdverse eventsTreatment groupsCOVID-19Administration of hydroxychloroquineReagan-Udall FoundationProportional hazards modelHealth systems researchHospitalized patientsElevated riskPropensity score methodsHazards modelHydroxychloroquinePatientsSignificant global threatPharmaceutical interventionsAzithromycinHealth recordsMortalityCOVID-19 pandemicCancer researchTreatment
2020
Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV
Zifodya JS, Duncan MS, So‐Armah K, Attia EF, Akgün KM, Rodriguez‐Barradas M, Marconi VC, Budoff MJ, Bedimo RJ, Alcorn CW, Hoo G, Butt AA, Kim JW, Sico JJ, Tindle HA, Huang L, Tate JP, Justice AC, Freiberg MS, Crothers K. Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV. Journal Of The American Heart Association 2020, 9: e017645. PMID: 33222591, PMCID: PMC7763776, DOI: 10.1161/jaha.120.017645.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaCVD risk factorsCVD eventsRisk factorsCAP severityHIV infectionHIV statusSevere community-acquired pneumoniaVeterans Aging Cohort StudyIncident CVD eventsCardiovascular disease eventsMultivariable-adjusted modelsAging Cohort StudyCox regression analysisDate of admissionMultivariable-adjusted analysesHigher mortality riskBackground HospitalizationCAP hospitalizationsHIV-uninfectedCardiovascular eventsIncident CVDCohort studyCVD riskUS veteransExtracting lung function measurements to enhance phenotyping of chronic obstructive pulmonary disease (COPD) in an electronic health record using automated tools
Akgün KM, Sigel K, Cheung KH, Kidwai-Khan F, Bryant AK, Brandt C, Justice A, Crothers K. Extracting lung function measurements to enhance phenotyping of chronic obstructive pulmonary disease (COPD) in an electronic health record using automated tools. PLOS ONE 2020, 15: e0227730. PMID: 31945115, PMCID: PMC6964890, DOI: 10.1371/journal.pone.0227730.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesData MiningElectronic Health RecordsForced Expiratory VolumeHealth Information SystemsHospitalizationHumansLungNatural Language ProcessingPulmonary Disease, Chronic ObstructiveSeverity of Illness IndexSoftwareUnited StatesUnited States Department of Veterans AffairsVeteransVital CapacityConceptsChronic obstructive pulmonary diseaseVeterans Aging Cohort StudyObstructive pulmonary diseaseFEV1 valuesPulmonary diseasePhenotyping of patientsPulmonary function testsAging Cohort StudyLung function measurementsElectronic health record dataHealth record dataStructured electronic health record dataPositive predictive valueElectronic health recordsAirflow obstructionChart reviewCohort studyExpiratory volumeCOPD phenotypesFunction testsVital capacityFEV1 measurementsDATA SOURCESPredictive valueClinical notes
2019
Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty
Justice A, Tate J. Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty. AIDS Research And Human Retroviruses 2019, 35: 1023-1033. PMID: 31565954, PMCID: PMC7133454, DOI: 10.1089/aid.2019.0136.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort Study (VACS) IndexPhysiologic frailtyStudy indicesRoutine clinical laboratory testsClinical laboratory testsVACS IndexCause mortalityFragility fracturesHIV infectionFunctional declineCognitive declineSerious fallsFrailtyRelated outcomesEarly indicatorMortalityLaboratory testsIndexDeliriumHospitalizationPneumoniaHIVInfectionPatterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study
Rentsch CT, Edelman EJ, Justice AC, Marshall BDL, Xu K, Smith AH, Crystal S, Gaither JR, Gordon AJ, Smith RV, Kember RL, Polimanti R, Gelernter J, Fiellin DA, Tate JP, Kranzler HR, Becker WC. Patterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study. AIDS And Behavior 2019, 23: 3340-3349. PMID: 31317364, PMCID: PMC7344341, DOI: 10.1007/s10461-019-02608-3.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid receiptCohort studyLong-term opioid therapyVeterans Aging Cohort StudyLatent growth mixture modellingPrescription opioid receiptObservational cohort studyAging Cohort StudyOpioid therapyCause mortalityHepatitis COpioid prescriptionsFuture prevention researchOUD diagnosisGrowth mixture modellingUS veteransHigh prevalenceLow doseHigh incidenceUse disordersPrevention researchGenetic discoveriesReceiptHIV
2018
Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals
Justice AC, Gordon KS, Skanderson M, Edelman EJ, Akgün KM, Gibert CL, Re V, Rimland D, Womack JA, Wyatt CM, Tate JP, Team V. Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals. AIDS 2018, 32: 739-749. PMID: 29543653, PMCID: PMC5868488, DOI: 10.1097/qad.0000000000001756.Peer-Reviewed Original ResearchConceptsAdverse health outcomesHIV statusUninfected individualsVACS IndexMedication countUS Veterans Affairs Healthcare SystemHealth outcomesVeterans Affairs Healthcare SystemRisk of hospitalizationSeverity of illnessHIV-1 RNAHIV-positive individualsRisk of mortalityDose responseRace/ethnicityPolypharmacyFiscal year 2009HospitalizationMedicationsMortalityHealthcare systemAntiretroviralsOutcomesAssociationRisk
2015
Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011
Rentsch C, Tate JP, Akgün KM, Crystal S, Wang KH, Ryan Greysen S, Wang EA, Bryant KJ, Fiellin DA, Justice AC, Rimland D. Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011. AIDS And Behavior 2015, 20: 555-564. PMID: 25711299, PMCID: PMC4550577, DOI: 10.1007/s10461-015-1025-y.Peer-Reviewed Original ResearchConceptsAlcohol-related diagnosesHospitalization ratesUnited States veteransUninfected patientsCause hospitalizationHIV infectionStates veteransUninfected individualsMultivariable Cox proportional hazards modelsCox proportional hazards modelOverall hospitalization rateProportional hazards modelCancer admissionsAntiretroviral therapyMultivariable adjustmentHIV serostatusComorbidity variablesHospitalization trendsRelative riskHigh riskHazards modelHIVHospitalizationDisease categoriesPatientsMedicare and Medicaid enrollment and outside hospitalizations among HIV-infected and uninfected veterans engaged in VA care: a retrospective cohort study
Chang H, Tate J, Justice AC, Ohl ME. Medicare and Medicaid enrollment and outside hospitalizations among HIV-infected and uninfected veterans engaged in VA care: a retrospective cohort study. BMC Health Services Research 2015, 15: 27. PMID: 25608566, PMCID: PMC4307747, DOI: 10.1186/s12913-015-0684-8.Peer-Reviewed Original ResearchConceptsUninfected veteransNon-VA useMedicaid enrollmentVA careLower oddsHealth systemVeterans Administration Health SystemMore frequent hospitalizationsVeterans 65 yearsCohort of HIVRetrospective cohort studyGreater illness severityNon-VA hospitalizationsHigh rateHIV careCohort studyFrequent hospitalizationsHIV infectionHospital admissionIllness severityPoor outcomeWorse outcomesHospitalizationHIVService Medicare
2014
An Adapted Frailty-Related Phenotype and the VACS Index as Predictors of Hospitalization and Mortality in HIV-Infected and Uninfected Individuals
Akgün KM, Tate JP, Crothers K, Crystal S, Leaf DA, Womack J, Brown TT, Justice AC, Oursler KK. An Adapted Frailty-Related Phenotype and the VACS Index as Predictors of Hospitalization and Mortality in HIV-Infected and Uninfected Individuals. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 67: 397-404. PMID: 25202921, PMCID: PMC4213242, DOI: 10.1097/qai.0000000000000341.Peer-Reviewed Original ResearchConceptsHIV-1 RNAUndetectable HIV-1 RNAVACS IndexUninfected individualsHazard ratioC-statisticFrailty-related phenotypePredictors of hospitalizationCohort Study participantsLow physical activityAdverse health outcomesPhysiologic reserveGeriatric syndromesFrailty stateRisk factorsHospitalizationPhysical activityMortality riskHIVHealth behaviorsHealth outcomesSurvival analysisSystem biomarkersStudy participantsMortality
2013
Does Social Isolation Predict Hospitalization and Mortality Among HIV+ and Uninfected Older Veterans?
Greysen SR, Horwitz LI, Covinsky KE, Gordon K, Ohl ME, Justice AC. Does Social Isolation Predict Hospitalization and Mortality Among HIV+ and Uninfected Older Veterans? Journal Of The American Geriatrics Society 2013, 61: 1456-1463. PMID: 23927911, PMCID: PMC3773301, DOI: 10.1111/jgs.12410.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudySocial isolation scoresHuman immunodeficiency virusCause mortalityHospital admissionUninfected groupOlder veteransSocial isolationGreater riskAging Cohort StudyHIV-positive individualsMultivariable regression analysisVA Medical CenterBaseline survey responsesUninfected participantsIncident hospitalizationCohort studyClinical featuresHIV statusImmunodeficiency virusHigh prevalenceMedical CenterMultivariable regressionHospitalizationOlder individualsRisk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans
Akgün KM, Gordon K, Pisani M, Fried T, McGinnis KA, Tate JP, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Risk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2013, 62: 52-59. PMID: 23111572, PMCID: PMC4182723, DOI: 10.1097/qai.0b013e318278f3fa.Peer-Reviewed Original ResearchConceptsVACS Index scoreMedical intensive care unit admissionIntensive care unit admissionVeterans Aging Cohort StudyCare unit admissionMICU admissionIndex scoreRisk factorsHazardous alcohol useVACS IndexUnit admissionCurrent smokingChronic obstructive pulmonary diseaseAlcohol useNon-AIDS diseasesVA administrative databasesMultivariable Cox regressionSurvival of HIVObstructive pulmonary diseaseAging Cohort StudyElectronic medical recordsAntiretroviral therapyCause mortalityPrior AIDSPrior cancer
2010
Patient and Provider-Reported Symptoms in the Post-cART Era
Edelman EJ, Gordon K, Justice AC. Patient and Provider-Reported Symptoms in the Post-cART Era. AIDS And Behavior 2010, 15: 853-861. PMID: 20490910, PMCID: PMC3118476, DOI: 10.1007/s10461-010-9706-z.Peer-Reviewed Original ResearchConceptsPatient-reported symptomsPost-cART eraClinical outcomesVeterans Aging Cohort StudyAging Cohort StudyHealth-related qualityBaseline survey dataCohort studySymptoms patientsHigh burdenSecondary analysisSymptomsPatientsPrimary providersGold standardKappa scoresHospitalizationRegression analysisMortalityOutcomesProvidersPoor agreementHRQoLHIVPrevalence
1999
The Relationship Between Clinical Assessments of Nutritional Status and Adverse Outcomes in Older Hospitalized Medical Patients
Covinsky K, Martin G, Beyth R, Justice A, Sehgal A, Landefeld C. The Relationship Between Clinical Assessments of Nutritional Status and Adverse Outcomes in Older Hospitalized Medical Patients. Journal Of The American Geriatrics Society 1999, 47: 532-538. PMID: 10323645, DOI: 10.1111/j.1532-5415.1999.tb02566.x.Peer-Reviewed Original ResearchConceptsNursing home useAcute illness severityAdverse outcomesIllness severityNutritional statusClinical assessmentMalnourished patientsHospital admissionSubjective Global AssessmentProspective cohort studyTertiary care hospitalHome useIndex of comorbidityGeneral medical servicesPhysical exam findingsHospitalized older peopleYear of dischargeLogistic regression modelsNourished patientsSurrogate interviewsHospital outcomesChart reviewCohort studyCare hospitalHospitalized patients
1998
The Relation Between Health Status Changes and Patient Satisfaction in Older Hospitalized Medical Patients
Covinsky K, Rosenthal G, Chren M, Justice A, Fortinsky R, Palmer R, Landefeld C. The Relation Between Health Status Changes and Patient Satisfaction in Older Hospitalized Medical Patients. Journal Of General Internal Medicine 1998, 13: 223-229. PMID: 9565384, PMCID: PMC1496938, DOI: 10.1046/j.1525-1497.1998.00071.x.Peer-Reviewed Original ResearchConceptsPatient satisfactionMean satisfaction scoreHealth statusMedical patientsHospital careSatisfaction scoresProspective cohort studyOlder medical patientsPatient satisfaction questionnairePatient outcome measuresTendency of patientsGlobal healthHealth status changesHospital outcomesCohort studyGreater satisfactionStable healthHealthy patientsTeaching hospitalOutcome measuresDaily livingPatientsAdmissionMultivariate analysisSimilar satisfaction
1997
Measuring Prognosis and Case Mix in Hospitalized Elders
Covinsky K, Justice A, Rosenthal G, Palmer R, Landefeld C. Measuring Prognosis and Case Mix in Hospitalized Elders. Journal Of General Internal Medicine 1997, 12: 203-208. PMID: 9127223, PMCID: PMC1497092, DOI: 10.1046/j.1525-1497.1997.012004203.x.Peer-Reviewed Original ResearchConceptsNursing home useCase mixCharlson scoreHospital mortalityHospitalized eldersPrimary nurseHospital costsPhysiologic measuresNumber of ADLsPatient's primary nurseAcute Physiology ScoreCharlson comorbidity scoreOne-year mortalityHome useDaily living functionGeneral medical servicesCost of hospitalizationMeasures of functionHigh resource useCase-mix adjustment methodsComorbidity scoreChart reviewPhysiology ScoreADL functionMedical inpatients