2018
Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia
Khera R, Dharmarajan K, Wang Y, Lin Z, Bernheim SM, Wang Y, Normand ST, Krumholz HM. Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182777. PMID: 30646181, PMCID: PMC6324473, DOI: 10.1001/jamanetworkopen.2018.2777.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionPostdischarge mortalityHeart failureHRRP announcementReadmissions Reduction ProgramMedicare beneficiariesRisk-adjusted ratesMyocardial infarctionService Medicare beneficiariesReduction programsInterrupted time series frameworkHospital mortalityReduced readmissionsCohort studyPneumonia hospitalizationsReadmission ratesMAIN OUTCOMEPneumoniaMedicare dataHospitalizationHospitalMortalityReadmissionConcomitant harm
2017
Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease
Lindenauer PK, Dharmarajan K, Qin L, Lin Z, Gershon AS, Krumholz HM. Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease. American Journal Of Respiratory And Critical Care Medicine 2017, 197: 1009-1017. PMID: 29206052, PMCID: PMC5909167, DOI: 10.1164/rccm.201709-1852oc.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseSame respective groupsObstructive pulmonary diseaseVentilator supportPulmonary diseaseRisk of readmissionRisk of hospitalizationGeneral elderly populationGeneral Medicare populationRisk of deathDaily riskRespective groupsReadmission ratesHospital readmissionAbsolute riskMedicare populationReadmissionElderly populationMedicare beneficiariesHospitalizationClinical servicesFirst monthProlonged riskDeathLongitudinal outcomesThe medically managed patient with severe symptomatic aortic stenosis in the TAVR era: Patient characteristics, reasons for medical management, and quality of shared decision making at heart valve treatment centers
Dharmarajan K, Foster J, Coylewright M, Green P, Vavalle JP, Faheem O, Huang PH, Krishnaswamy A, Thourani VH, McCoy LA, Wang TY. The medically managed patient with severe symptomatic aortic stenosis in the TAVR era: Patient characteristics, reasons for medical management, and quality of shared decision making at heart valve treatment centers. PLOS ONE 2017, 12: e0175926. PMID: 28430791, PMCID: PMC5400246, DOI: 10.1371/journal.pone.0175926.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementTranscatheter aortic valve replacementPhysician-reported reasonsSevere symptomatic aortic stenosisSymptomatic aortic stenosisAortic valve replacementMedical managementAortic stenosisTreatment centersPatient characteristicsValve replacementTreatment optionsPatient preferencesTreatment decisionsInadequate vascular accessSevere symptomatic ASMedical record reviewFinal treatment decisionSurvey of patientsExperience of careSymptomatic ASTAVR eraRecord reviewVascular accessThirty-day
2016
Relationship Between Age and Trajectories of Rehospitalization Risk in Older Adults
Dharmarajan K, Hsieh A, Dreyer RP, Welsh J, Qin L, Krumholz HM. Relationship Between Age and Trajectories of Rehospitalization Risk in Older Adults. Journal Of The American Geriatrics Society 2016, 65: 421-426. PMID: 27874977, PMCID: PMC5310961, DOI: 10.1111/jgs.14583.Peer-Reviewed Original ResearchTreatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure
Dharmarajan K, Strait KM, Tinetti ME, Lagu T, Lindenauer PK, Lynn J, Krukas MR, Ernst FR, Li SX, Krumholz HM. Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure. Journal Of The American Geriatrics Society 2016, 64: 1574-1582. PMID: 27448329, PMCID: PMC4988873, DOI: 10.1111/jgs.14303.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal Cortex HormonesAgedAged, 80 and overAnti-Bacterial AgentsCardiotonic AgentsCohort StudiesComorbidityCross-Sectional StudiesDiureticsDrug Therapy, CombinationFemaleHeart FailureHospitalizationHumansMalePneumoniaPulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited StatesVasodilator AgentsConceptsChronic obstructive pulmonary diseaseAcute cardiopulmonary conditionsObstructive pulmonary diseaseHeart failureCardiopulmonary conditionsOlder adultsPulmonary diseasePremier Research DatabaseEpisodes of pneumoniaRetrospective cohort studyReal-world treatmentHF hospitalizationCohort studyHospital daysPneumonia hospitalizationsCOPD hospitalizationsClinical syndromeAcute conditionsPneumoniaDiagnostic uncertaintyResearch DatabaseHospitalizationDiagnostic categoriesU.S. hospitalsAdults
2015
Intravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2014
Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study
Ranasinghe I, Wang Y, Dharmarajan K, Hsieh AF, Bernheim SM, Krumholz HM. Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study. PLOS Medicine 2014, 11: e1001737. PMID: 25268126, PMCID: PMC4181962, DOI: 10.1371/journal.pmed.1001737.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMiddle-aged adultsTiming of readmissionHeart failureReadmission ratesAMI cohortReadmission diagnosesHF cohortReadmission riskMyocardial infarctionAge groupsRetrospective observational cohort studyIndex admission diagnosisObservational cohort studySimilar risk patternNon-cardiac diagnosisPneumonia cohortAdmission diagnosisElderly patientsCohort studyPatient characteristicsPrimary outcomePayer statusReadmissionHospitalizationNational Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010
Chaudhry SI, Khan RF, Chen J, Dharmarajan K, Dodson JA, Masoudi FA, Wang Y, Krumholz HM. National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010. Journal Of The American Heart Association 2014, 3: e001197. PMID: 25249298, PMCID: PMC4323804, DOI: 10.1161/jaha.114.001197.Peer-Reviewed Original Research
2013
Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure
Dharmarajan K, Masoudi FA, Spertus JA, Li SX, Krumholz HM. Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure. JAMA Internal Medicine 2013, 173: 1547-1549. PMID: 23797379, PMCID: PMC4043342, DOI: 10.1001/jamainternmed.2013.7717.Peer-Reviewed Original ResearchSpending more, doing more, or both? An alternative method for quantifying utilization during hospitalizations
Lagu T, Krumholz HM, Dharmarajan K, Partovian C, Kim N, Mody PS, Li S, Strait KM, Lindenauer PK. Spending more, doing more, or both? An alternative method for quantifying utilization during hospitalizations. Journal Of Hospital Medicine 2013, 8: 373-379. PMID: 23757115, PMCID: PMC4014449, DOI: 10.1002/jhm.2046.Peer-Reviewed Original ResearchVariation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States
Safavi KC, Dharmarajan K, Kim N, Strait KM, Li SX, Chen SI, Lagu T, Krumholz HM. Variation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States. Circulation 2013, 127: 923-929. PMID: 23355624, PMCID: PMC3688061, DOI: 10.1161/circulationaha.112.001088.Peer-Reviewed Original ResearchConceptsIntensive care unitHeart failureRisk-standardized mortalityICU admissionICU useCare unitPatient outcomesCoronary intensive care unitMedical intensive care unitNoninvasive positive pressure ventilationSurgical intensive care unitTop quartileGreater ICU useOverall heart failureTop quartile hospitalsICU admission ratePercent of patientsPremier Perspective databaseHeart failure patientsPositive pressure ventilationRate of admissionHigh-cost settingsQuality of careHF admissionsICU daysDiagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Bernheim SM, Suter LG, Drye EE, Krumholz HM. Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA 2013, 309: 355-363. PMID: 23340637, PMCID: PMC3688083, DOI: 10.1001/jama.2012.216476.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCommon readmission diagnosesAcute MI hospitalizationReadmission diagnosesDays of hospitalizationPatient demographic characteristicsHeart failureMyocardial infarctionHF hospitalizationReadmission timingPneumonia hospitalizationsMedian timeMI hospitalizationMedicare feeIndex HF hospitalizationIndex pneumonia hospitalizationProportion of patientsDemographic characteristicsService claims dataMI cohortPneumonia cohortHF cohortCondition categoriesHospitalizationReadmission