2024
Hospital COVID-19 Burden and Adverse Event Rates
Metersky M, Rodrick D, Ho S, Galusha D, Timashenka A, Grace E, Marshall D, Eckenrode S, Krumholz H. Hospital COVID-19 Burden and Adverse Event Rates. JAMA Network Open 2024, 7: e2442936. PMID: 39495512, PMCID: PMC11581512, DOI: 10.1001/jamanetworkopen.2024.42936.Peer-Reviewed Original ResearchConceptsCOVID-19 burdenHospital admissionPatient safetyRelative riskCohort studyStudy of hospital admissionsAcute care hospitalsRisk-adjustment variablesRisk-adjusted ratesMedicare hospital admissionsCOVID-19 pandemicStaffing shortagesHospital characteristicsMain OutcomesHospital resilienceSurge capacityMedicare patientsCare hospitalHighest burdenPrevent declinesPatient admissionsStudy sampleElixhauser comorbiditiesCOVID-19Low burden
2020
Renin–angiotensin system blockers and susceptibility to COVID-19: an international, open science, cohort analysis
Morales DR, Conover MM, You SC, Pratt N, Kostka K, Duarte-Salles T, Fernández-Bertolín S, Aragón M, DuVall SL, Lynch K, Falconer T, van Bochove K, Sung C, Matheny ME, Lambert CG, Nyberg F, Alshammari TM, Williams AE, Park RW, Weaver J, Sena AG, Schuemie MJ, Rijnbeek PR, Williams RD, Lane JCE, Prats-Uribe A, Zhang L, Areia C, Krumholz HM, Prieto-Alhambra D, Ryan PB, Hripcsak G, Suchard MA. Renin–angiotensin system blockers and susceptibility to COVID-19: an international, open science, cohort analysis. The Lancet Digital Health 2020, 3: e98-e114. PMID: 33342753, PMCID: PMC7834915, DOI: 10.1016/s2589-7500(20)30289-2.Peer-Reviewed Original ResearchAngiotensin receptor blockersCalcium channel blockersAcute respiratory distress syndromeAcute kidney injuryHospital admissionRespiratory distress syndromeCOVID-19 diagnosisKidney injuryDistress syndromeDrug classesCohort analysisCOVID-19Renin-angiotensin system blockersThiazide-like diureticsBaseline patient characteristicsUse of ACEIsPost-authorisation studiesUK National InstituteRelative risk differenceNational InstituteCombination useMedical Research CouncilAustralian National HealthElectronic health recordsAntihypertensive usersPost-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States
Khera R, Wang Y, Bernheim SM, Lin Z, Krumholz HM. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States. The BMJ 2020, 368: l6831. PMID: 31941686, PMCID: PMC7190056, DOI: 10.1136/bmj.l6831.Peer-Reviewed Original ResearchConceptsAcute care utilizationAcute myocardial infarctionRetrospective cohort studyHeart failureCare utilizationPost-discharge periodEmergency departmentMyocardial infarctionDay mortalityCohort studyHospital admissionObservation unitAcute careNational retrospective cohort studyPost-acute care utilizationHospital Readmissions Reduction ProgramObservation unit carePost-discharge mortalityDay readmission rateRisk of deathReadmissions Reduction ProgramReadmission reduction initiativesReadmission ratesUnit careInpatient unitQuality of Care for Patients Hospitalized for Heart Failure in China
Gupta A, Yu Y, Tan Q, Liu S, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J. Quality of Care for Patients Hospitalized for Heart Failure in China. JAMA Network Open 2020, 3: e1918619. PMID: 31913489, PMCID: PMC6991250, DOI: 10.1001/jamanetworkopen.2019.18619.Peer-Reviewed Original ResearchConceptsQuality of careHospital levelHF careEligible patientsComposite performance scoreEvidence-based β-blockersAngiotensin-converting enzyme inhibitorRetrospective cross-sectional studyVentricular ejection fraction assessmentMedian rateAngiotensin receptor blockersMedian patient ageHeart failure epidemicCross-sectional studyEjection fraction assessmentMedian odds ratioPerformance scoresHF hospitalizationReceptor blockersPatient ageHeart failureHospital admissionMedical recordsOdds ratioMAIN OUTCOME
2019
Population Impact of Generic Valsartan Recall
Jackevicius CA, Krumholz HM, Chong A, Koh M, Ozaki AF, Austin PC, Udell JA, Ko DT. Population Impact of Generic Valsartan Recall. Circulation 2019, 141: 411-413. PMID: 31707798, DOI: 10.1161/circulationaha.119.044494.Peer-Reviewed Original ResearchConceptsNational Ambulatory Care Reporting System databaseEmergency department visitsRegistered Persons DatabaseOntario Registered Persons DatabaseReporting System databaseHealth care systemDrug recallsSegmented regression analysisBaseline comorbiditiesOral medicationsDepartment visitsHospital admissionMedication useClinical outcomesDischarge diagnosisVital statusChronic conditionsHealthcare databasesHealth CanadaCare systemCanadian InstituteHealth informationPopulation impactPatientsRegression analysisComparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarction
2018
Prediction of ICU Readmissions Using Data at Patient Discharge
Pakbin A, Rafi P, Hurley N, Schulz W, Krumholz M, Mortazavi J. Prediction of ICU Readmissions Using Data at Patient Discharge. Annual International Conference Of The IEEE Engineering In Medicine And Biology Society (EMBC) 2018, 00: 4932-4935. PMID: 30441449, DOI: 10.1109/embc.2018.8513181.Peer-Reviewed Original ResearchConceptsICU readmissionHigher health care costsSame hospital admissionElectronic health record dataPoor patient outcomesHealth record dataLong-term riskHealth care costsICU dischargeUnplanned readmissionHospital admissionPatient dischargePatient outcomesICU casesClinical careReadmissionCare costsRecord data
2017
Urban–Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment–Elevation Myocardial Infarction in China From 2001 to 2011
Li X, Murugiah K, Li J, Masoudi FA, Chan PS, Hu S, Spertus JA, Wang Y, Downing NS, Krumholz HM, Jiang L. Urban–Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment–Elevation Myocardial Infarction in China From 2001 to 2011. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003905. PMID: 29158421, PMCID: PMC6312853, DOI: 10.1161/circoutcomes.117.003905.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChinaDisease ManagementFemaleHealthcare DisparitiesHospital MortalityHospitalizationHospitals, RuralHospitals, UrbanHumansMaleMiddle AgedOdds RatioQuality ImprovementRetrospective StudiesRural PopulationST Elevation Myocardial InfarctionSurvival RateTime FactorsUrban PopulationConceptsEvidence-based treatmentsMyocardial infarctionEnzyme inhibitors/angiotensin receptor blockersRural hospitalsST-segment elevation myocardial infarctionUrban-rural disparitiesAngiotensin receptor blockersElevation myocardial infarctionAdjusted odds ratioResource-intensive careRisk-adjusted ratesHospital deathReperfusion therapyReceptor blockersHospital admissionCardiac facilitiesPatient outcomesOdds ratioCare persistUrban hospitalΒ-blockersBetter outcomesRural careHealthcare resourcesST segmentIncorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization
Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM. Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke 2017, 48: 3101-3107. PMID: 28954922, DOI: 10.1161/strokeaha.117.017960.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesElectronic health record dataHealth record dataStroke severityClaims dataMortality rateAmerican Heart Association/American Stroke AssociationHealth Stroke Scale scoreRisk variablesMedicaid ServicesRisk adjustmentMedian risk-standardized mortality rateGuidelines-Stroke registryLow-mortality hospitalsStroke Scale scoreAcute ischemic strokeAmerican Stroke AssociationOdds of mortalityMortality measuresRecord dataIschemic stroke hospitalizationsHigh-mortality hospitalsService claims dataRisk-adjustment variablesHospital admission
2016
Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Spatz ES, Lipska KJ, Dai Y, Bao H, Lin Z, Parzynski CS, Altaf FK, Joyce EK, Montague JA, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations. Medical Care 2016, 54: 528-537. PMID: 26918404, PMCID: PMC5356461, DOI: 10.1097/mlr.0000000000000518.Peer-Reviewed Original ResearchConceptsHeart failure measuresAccountable care organizationsAcute admission ratesHeart failureAdmission ratesNational ratesUnplanned hospital admissionsHeart failure cohortRisk-adjustment variablesPopulation-based measuresCare organizationsOutcome measure developmentIntraclass correlation coefficientHospital admissionDiabetes measuresFailure cohortChronic conditionsMedicare feeDiabetesService beneficiariesPatientsMeet criteriaMeasures of qualitySocioeconomic statusPerformance categoriesSex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study
Du X, Spatz ES, Dreyer RP, Hu S, Wu C, Li X, Li J, Wang S, Masoudi FA, Spertus JA, Nasir K, Krumholz HM, Jiang L, Group F. Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study. Journal Of The American Heart Association 2016, 5: e002157. PMID: 26903002, PMCID: PMC4802449, DOI: 10.1161/jaha.115.002157.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careEvidence-based therapiesMyocardial infarctionClinical profileHospitalization ratesST-segment elevation myocardial infarction presentationSex differencesMyocardial infarction presentationYounger age groupsProportion of womenMyocardial infarction hospitalizationsEarly aspirinHospital deathCardiac eventsHospital admissionMedian ageSymptom onsetChina PatientRetrospective studyAdmission timeHigh riskSex disparitiesPatients
2015
Admission glucose and in-hospital mortality in patients with acute myocardial infarction, with and without diabetes, from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis
Zhao S, Murugiah K, Li X, Li J, Li N, Xu Z, Cheng C, Mao H, Wang Q, Krumholz H, Jiang L, Group O. Admission glucose and in-hospital mortality in patients with acute myocardial infarction, with and without diabetes, from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis. The Lancet 2015, 386: s43. DOI: 10.1016/s0140-6736(15)00624-8.Peer-Reviewed Original ResearchAcute myocardial infarctionBlood glucose concentrationHospital mortalityMyocardial infarctionChinese patientsMortality riskGlucose concentrationAcute Myocardial Infarction StudyProportion of patientsHospital mortality riskMyocardial Infarction StudyUS National HeartEuglycaemic patientsAdmission glucoseDiabetes statusFamily Planning CommissionHospital admissionPatient characteristicsGlucose categoriesClinical statusBlood InstituteNational HeartNational HealthCardiovascular diseaseRetrospective analysisMedication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures
Allen LA, Fonarow GC, Liang L, Schulte PJ, Masoudi FA, Rumsfeld JS, Ho PM, Eapen ZJ, Hernandez AF, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures. Circulation 2015, 132: 1347-1353. PMID: 26316616, PMCID: PMC4941099, DOI: 10.1161/circulationaha.115.014281.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBody Mass IndexCardiovascular AgentsComorbidityContraindicationsCross-Sectional StudiesDrug HypersensitivityDrug PrescriptionsDrug SubstitutionDrug Therapy, CombinationDrug UtilizationEvidence-Based MedicineFemaleGuideline AdherenceHeart FailureHospitalsHumansMaleMedication AdherenceMiddle AgedPatient AdmissionPatient DischargePolypharmacyPractice Guidelines as TopicQuality Assurance, Health CareConceptsHF quality measuresHydralazine/isosorbide dinitrateAngiotensin receptor blockersMedication groupHeart failureAldosterone antagonistsReceptor blockersMedication regimenIsosorbide dinitrateNew medicationsΒ-blockersEnzyme inhibitorsGuideline-directed medical therapyInitiation of angiotensinPrimary discharge diagnosisQuarter of patientsPatient's medication regimenHospital quality measuresAdequate prescribingMedication initiationHospital dischargeHospital admissionMedical therapyGuideline recommendationsDischarge diagnosisNational Quality Assessment of Early Clopidogrel Therapy in Chinese Patients With Acute Myocardial Infarction (AMI) in 2006 and 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)–Retrospective AMI Study
Zhang L, Desai NR, Li J, Hu S, Wang Q, Li X, Masoudi FA, Spertus JA, Nuti SV, Wang S, Krumholz HM, Jiang L, Group T. National Quality Assessment of Early Clopidogrel Therapy in Chinese Patients With Acute Myocardial Infarction (AMI) in 2006 and 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)–Retrospective AMI Study. Journal Of The American Heart Association 2015, 4: e001906. PMID: 26163041, PMCID: PMC4608074, DOI: 10.1161/jaha.115.001906.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleChinaClopidogrelDrug Administration ScheduleFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionNational Health ProgramsPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareResidence CharacteristicsRetrospective StudiesRisk FactorsRural Health ServicesTiclopidineTime FactorsTreatment OutcomeUrban Health ServicesConceptsAcute myocardial infarctionEarly clopidogrel useClopidogrel therapyClopidogrel useRural hospitalsMyocardial infarctionQuality improvement initiativesEligible patientsClopidogrel administrationReperfusion therapyCardiac eventsHospital admissionAMI patientsChina PatientChinese patientsPatterns of useUrban hospitalPatientsClopidogrelChinese trialsHospitalTherapyEarly useAMI studyImprovement initiativesWide Variation Found In Hospital Facility Costs For Maternity Stays Involving Low-Risk Childbirth
Xu X, Gariepy A, Lundsberg LS, Sheth SS, Pettker CM, Krumholz HM, Illuzzi JL. Wide Variation Found In Hospital Facility Costs For Maternity Stays Involving Low-Risk Childbirth. Health Affairs 2015, 34: 1212-1219. PMID: 26153317, DOI: 10.1377/hlthaff.2014.1088.Peer-Reviewed Original ResearchConceptsCesarean deliveryHospital costsMaternity staysSerious maternal morbidityNationwide Inpatient SampleCoordination of careValue of careMaternal morbidityHospital admissionInpatient SampleDelivery system reformRural hospitalsUS hospitalsHospital practiceSafe reductionHospitalChildbirthStayLong stayHigh rateCareLower proportionUnited StatesFacility costsTrajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study
Dharmarajan K, Hsieh AF, Kulkarni VT, Lin Z, Ross JS, Horwitz LI, Kim N, Suter LG, Lin H, Normand SL, Krumholz HM. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. The BMJ 2015, 350: h411. PMID: 25656852, PMCID: PMC4353309, DOI: 10.1136/bmj.h411.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyHeart failureRisk of deathMyocardial infarctionFirst readmissionAbsolute riskOlder patientsCohort studyRelative riskMedicare feeService beneficiariesRisk of readmissionGeneral elderly populationGeneral older populationRisk trajectoriesHigh-risk periodHospital dischargeHospital admissionDischarge diagnosisAdverse outcomesReadmissionHospitalizationTrajectories of riskElderly population
2014
ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data
Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, Spertus JA, Krumholz HM, Jiang L, Group F. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. The Lancet 2014, 385: 441-451. PMID: 24969506, PMCID: PMC4415374, DOI: 10.1016/s0140-6736(14)60921-1.Peer-Reviewed Original ResearchMeSH KeywordsAgedAspirinChinaClopidogrelFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHospitals, RuralHospitals, UrbanHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionPatient AdmissionPercutaneous Coronary InterventionQuality of Health CareRetrospective StudiesTiclopidineTreatment OutcomeConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionHospital mortalityHospital admissionMyocardial infarctionRetrospective analysisPrimary percutaneous coronary interventionAcute myocardial infarction admissionsProportion of patientsUse of aspirinPercutaneous coronary interventionMyocardial infarction admissionsTwo-stage random sampling designQuality of careAnalysis of treatmentBaseline characteristicsCardiac eventsHospital outcomesHospital stayCoronary interventionFamily Planning CommissionClinical profileHospital recordsMedian lengthSTEMI admissionsHospital variation in risk-standardized hospital admission rates from US EDs among adults
Capp R, Ross JS, Fox JP, Wang Y, Desai MM, Venkatesh AK, Krumholz HM. Hospital variation in risk-standardized hospital admission rates from US EDs among adults. The American Journal Of Emergency Medicine 2014, 32: 837-843. PMID: 24881514, DOI: 10.1016/j.ajem.2014.03.033.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency departmentAdmission ratesClinical characteristicsED visitsHospital factorsClinical factorsAdult ED visitsUS emergency departmentsHospital teaching statusCross-sectional analysisPatient characteristicsHospital admissionHospital variationPatientsTeaching statusHospitalED dataVisitsRepresentative sampleAdultsRural locationsAdmissionFactorsNational variations
2013
Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Suter LG, Bernheim SM, Drye EE, Krumholz HM. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions. The BMJ 2013, 347: f6571. PMID: 24259033, PMCID: PMC3898430, DOI: 10.1136/bmj.f6571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyReadmission diagnosesReadmission ratesHeart failureMyocardial infarctionCohort studySpecific diagnosisReadmission performanceHospital readmission performancePatterns of readmissionDay readmission rateRisk-standardized readmission ratesLow performing hospitalsHospital performanceHigh performing hospitalsReadmission timingDay readmissionHospital stayIndex admissionHospital dischargeReadmission patternsHospital admissionCommon diagnosisMedian timeAge and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®
Lichtman JH, Wang Y, Jones SB, Leifheit-Limson EC, Shaw LJ, Vaccarino V, Rumsfeld JS, Krumholz HM, Curtis JP. Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®. American Heart Journal 2013, 167: 376-383. PMID: 24576523, DOI: 10.1016/j.ahj.2013.11.001.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionComplication rateOlder womenPCI typeYoung womenInhospital mortalityMortality riskAge groupsElective percutaneous coronary interventionPercutaneous coronary intervention (PCI) proceduresInhospital complication rateRate of complicationsHigh complication rateRisk-adjusted analysisRisk-adjusted mortalityCoronary intervention proceduresUnadjusted complication rateSex-based differencesPCI patientsCathPCI RegistryCoronary interventionYounger patientsClinical factorsHospital admissionMore complications