2024
Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration
Wang K, Hendrickson Z, Miller M, Abel E, Skanderson M, Erdos J, Womack J, Brandt C, Desai M, Han L. Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration. Medical Care 2024, 62: 458-463. PMID: 38848139, DOI: 10.1097/mlr.0000000000002017.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationElectronic health recordsResidential addressesHealth recordsHealth AdministrationLeveraging electronic health recordsInfluence health care utilizationVeterans Health Administration dataAssociations of sociodemographicsHealth care utilizationHealth care systemPatient's residential addressCross-sectional analysisGeneralized logistic regressionCare utilizationHealth systemResidential mobilitySubstance use disordersCare systemPatient's residenceLogistic regressionVeteransMultinomial outcomesHealthOdds
2023
Distressing symptoms after major surgery among community‐living older persons
Gill T, Han L, Murphy T, Feder S, Gahbauer E, Leo‐Summers L, Becher R. Distressing symptoms after major surgery among community‐living older persons. Journal Of The American Geriatrics Society 2023, 71: 2430-2440. PMID: 37010784, PMCID: PMC10524276, DOI: 10.1111/jgs.18357.Peer-Reviewed Original ResearchConceptsCommunity-living older personsMajor surgeryDistressing symptomsArea Deprivation IndexOlder personsSocioeconomic disadvantageCommunity-living personsTiming of surgeryProspective longitudinal studyYears of ageQuality of lifeSymptom burdenNonelective surgeryPresurgery valuesElective surgeryMultivariable analysisFunctional outcomeNonelective proceduresChronic conditionsSurgerySymptomsProportional increaseMedicaid eligibilityDeprivation indexMonthsAntibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study
Datta R, Han L, Doyle M, Allore H, Sanft T, Quagliarello V, Juthani-Mehta M. Antibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study. Palliative Medicine 2023, 37: 793-798. PMID: 36999898, DOI: 10.1177/02692163231162889.Peer-Reviewed Original ResearchConceptsAdverse drug eventsAntibiotic therapyDrug eventsAdvanced cancerOlder adultsIndex admissionPalliative chemotherapyCohort studyTertiary care centerHospitalized older adultsPalliative care providersMultidrug-resistant organismsMean ageCommon tumorsCare centerCare providersRatio of daysSolid tumorsMultivariable testingPatientsTherapyStandardized criteriaCancerMean timeAdultsDissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Hwang U, Runels T, Han L, Gruber E, McQuown C, Ragsdale L, Jetter E, Rossomano N, Javier D. Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Academic Emergency Medicine 2023, 30: 270-277. PMID: 36653961, DOI: 10.1111/acem.14665.Peer-Reviewed Original ResearchConceptsVA emergency departmentEmergency departmentOlder veteransED visitsVA Corporate Data WarehouseAge-friendly careIndex ED visitVeterans Affairs hospitalYears of ageCorporate Data WarehouseScreening prevalencePoor outcomeStandardization of practiceMean ageVisit encountersPotential confoundingEmergency careGreater oddsExtended careDemographic dataOlder adultsLevel 1Observational evaluationCarePandemic year
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareMilitary sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women
Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. Journal Of Hypertension 2022, 40: 2307-2315. PMID: 35983872, DOI: 10.1097/hjh.0000000000003267.Peer-Reviewed Original ResearchConceptsIncident hypertensionRisk factorsPsychiatric disordersMultivariate Cox proportional hazards modelVeterans Health Administration dataGreater riskCox proportional hazards modelTrauma-related psychiatric disordersMiddle-aged veteransCardiovascular risk factorsBaseline blood pressureElevated cardiovascular riskLarge prospective cohortHealth Administration dataMiddle-aged menProportional hazards modelSex-specific analysesPosttraumatic stress disorderMilitary sexual traumaCardiovascular riskCohort studyProspective cohortBlood pressureTreatment attenuatesCardiovascular impactSelf-reported and actigraphic short sleep duration in older adults.
Miner B, Stone KL, Zeitzer JM, Han L, Doyle M, Blackwell T, Gill TM, Redeker NS, Hajduk A, Yaggi H. Self-reported and actigraphic short sleep duration in older adults. Journal Of Clinical Sleep Medicine 2022, 18: 403-413. PMID: 34338629, PMCID: PMC8804982, DOI: 10.5664/jcsm.9584.Peer-Reviewed Original ResearchConceptsShort sleep durationSelf-reported sleep durationSleep durationOsteoporotic fracturesAdverse outcomesOlder personsOlder adultsMen Sleep StudyNormal sleep durationActigraphic sleep durationDaytime sleepinessMultivariable modelShort sleepSleep studiesUnnecessary interventionsSymptom awarenessAverage ageHealth outcomesAge groupsLogistic regressionFalse negativesWomenObesityOutcomesMenRisk Factors Associated with Healthcare Utilization for Spine Pain
Higgins DM, Han L, Kerns RD, Driscoll MA, Heapy AA, Skanderson M, Lisi AJ, Mattocks KM, Brandt C, Haskell SG. Risk Factors Associated with Healthcare Utilization for Spine Pain. Pain Medicine 2022, 23: 1423-1433. PMID: 34999899, DOI: 10.1093/pm/pnab351.Peer-Reviewed Original ResearchConceptsSpine pain careSpine painHealthcare utilizationPain careRisk factorsPain episodesObservation periodNew episodesMultivariable logistic regression modelPotential risk factorsOutpatient visit dataLogistic regression analysisMental health conditionsBaseline observation periodLogistic regression modelsBaseline characteristicsOutpatient visitsClinical correlatesContinued careLower oddsPainVisit dataContinued episodesHealth conditionsCare
2021
Association Between Neighborhood Disadvantage and Functional Well-being in Community-Living Older Persons
Gill TM, Zang EX, Murphy TE, Leo-Summers L, Gahbauer EA, Festa N, Falvey JR, Han L. Association Between Neighborhood Disadvantage and Functional Well-being in Community-Living Older Persons. JAMA Internal Medicine 2021, 181: 1297-1304. PMID: 34424276, PMCID: PMC8383163, DOI: 10.1001/jamainternmed.2021.4260.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedFemaleFunctional StatusHealthy Life ExpectancyHousing QualityHumansIndependent LivingLongitudinal StudiesMaleMental HealthNeighborhood CharacteristicsPrognosisPsychosocial FunctioningQuality of LifeSocial Determinants of HealthSocioeconomic FactorsUnited StatesConceptsProspective longitudinal cohort studyCommunity-living older personsAge 70 yearsActive life expectancyLongitudinal cohort studyOlder personsCohort studyPrognostic factorsLife expectancyArea deprivation index scoreCommunity-living personsPrecipitating Events ProjectDeprivation index scoreDisabled life expectancyAge 90 yearsArea Deprivation IndexPublic health initiativesPublic health interventionsNeighborhood disadvantageGreater percentageResource-poor environmentsIndividual-level socioeconomic characteristicsMean ageMAIN OUTCOMEDaily livingSex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization
Haskell SG, Han L, Abel EA, Bastian L, Driscoll M, Dziura J, Burg MM, Skanderson M, Brandt CA. Sex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization. Journal Of Women's Health 2021, 31: 71-78. PMID: 34388023, DOI: 10.1089/jwh.2021.0103.Peer-Reviewed Original ResearchConceptsPrimary care utilizationCare utilizationWomen veteransCare Assessment Need (CAN) scoreComplex high-risk patientsHigh-risk patientsRisk stratification toolPotential confounding factorsCorporate Data WarehouseSex differencesVA careVisit utilizationCare coordinationHigher oddsReproductive healthConfounding factorsVeterans AffairsPsychosocial variablesStrong associationQuintileWomenNeed scoresMenVeteransGood predictive accuracyVisual trajectories and risk of physical and cognitive impairment among older Chinese adults
Cao G, Wang K, Han L, Zhang Q, Yao S, Chen Z, Huang Z, Luo Y, Hu Y, Xu B. Visual trajectories and risk of physical and cognitive impairment among older Chinese adults. Journal Of The American Geriatrics Society 2021, 69: 2877-2887. PMID: 34111310, DOI: 10.1111/jgs.17311.Peer-Reviewed Original ResearchConceptsOlder Chinese adultsIADL disabilityCognitive impairmentChinese adultsADL disabilityFunctional impairmentCognitive functionMini-Mental State Examination scoreProgressive declineChinese Longitudinal Healthy Longevity SurveyState Examination scoreModerate declineGroup-based trajectory modelsKatz scaleLawton scalePotential confoundersLongevity SurveyImpairmentDecline trajectoriesChinese versionDisabilityLongitudinal studyAdultsRiskExamination scoresFunctional Effects of Intervening Illnesses and Injuries After Critical Illness in Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Ferrante LE. Functional Effects of Intervening Illnesses and Injuries After Critical Illness in Older Persons. Critical Care Medicine 2021, 49: 956-966. PMID: 33497167, PMCID: PMC8140984, DOI: 10.1097/ccm.0000000000004829.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overBody Mass IndexCognitionCritical IllnessEmergency Service, HospitalFemaleFrail ElderlyHealth StatusHospitalizationHumansLongitudinal StudiesMaleMental HealthPhysical Functional PerformanceProspective StudiesSelf EfficacySocioeconomic FactorsWounds and InjuriesConceptsEmergency department visitsCritical illnessDepartment visitsICU admissionFunctional outcomeFunctional statusFunctional declineOlder personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsTraditional risk factorsCommunity-living participantsCorresponding odds ratiosFunctional effectsProspective longitudinal studyHazard ratioRisk factorsOdds ratioHospitalizationPremorbid functionInjuryIllnessRestricted activityAnalytic sample
2020
Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes
Cohen AB, Han L, OʼLeary JR, Fried TR. Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes. Journal Of The American Geriatrics Society 2020, 69: 342-348. PMID: 33170957, PMCID: PMC7902349, DOI: 10.1111/jgs.16900.Peer-Reviewed Original ResearchConceptsDays of lifeHospital deathHigh-intensity treatmentMechanical ventilationTube placementHome residentsCardiopulmonary resuscitationNursing homesIntensive care unit admissionMinimum Data Set assessmentsCare unit admissionRetrospective cohort studyNursing home residentsHigh-intensity endMore nursing homesUnit admissionICU admissionCohort studySecondary outcomesPrimary outcomeHospital transferLife hospitalizationsSevere dementiaLife careDementia severityFunctional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Becher RD. Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons. Annals Of Surgery 2020, 273: 834-841. PMID: 33074902, PMCID: PMC8370041, DOI: 10.1097/sla.0000000000004438.Peer-Reviewed Original ResearchConceptsMajor surgeryED visitsRestricted activityFunctional statusFunctional declineOlder personsCommunity-living older personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsEmergency department visitsTraditional risk factorsCorresponding odds ratiosFunctional effectsIllness/injuryHazard ratioDepartment visitsFunctional recoveryFunctional outcomeRisk factorsOdds ratioHospitalizationSurgeryInjuryVisitsRisk Factors for Disability After Emergency Department Discharge in Older Adults
Nagurney JM, Han L, Leo‐Summers L, Allore HG, Gill TM. Risk Factors for Disability After Emergency Department Discharge in Older Adults. Academic Emergency Medicine 2020, 27: 1270-1278. PMID: 32673434, PMCID: PMC7749835, DOI: 10.1111/acem.14088.Peer-Reviewed Original ResearchConceptsLower extremity weaknessDisability burdenRisk factorsOlder adultsED visitsPhysical frailtyLongitudinal multivariable modelsEmergency department dischargeModifiable risk factorsCommunity-living personsCandidate risk factorsEmergency department experienceED dischargeNonmodifiable factorsMultivariable analysisRisk stratificationFunctional outcomeIndependent associationMultivariable modelOngoing longitudinal studyMonthly interviewsAnalytic sampleFunctional activityAdultsVisitsRisk Factors and Precipitants of Severe Disability Among Community-Living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE. Risk Factors and Precipitants of Severe Disability Among Community-Living Older Persons. JAMA Network Open 2020, 3: e206021. PMID: 32484551, PMCID: PMC7267844, DOI: 10.1001/jamanetworkopen.2020.6021.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overConnecticutDisability EvaluationDisabled PersonsEmergency Service, HospitalFemaleGlobal Burden of DiseaseHospitalizationHumansMaleProspective StudiesQuality of LifeRecovery of FunctionRisk FactorsSeverity of Illness IndexWounds and InjuriesConceptsEmergency department visitsRisk factorsCatastrophic disabilitySevere disabilityDepartment visitsProgressive disabilityOlder community-living adultsCommunity-living older personsIndependent risk factorProspective cohort studyCommunity-living personsGreater New HavenCommunity-living adultsPotential risk factorsCandidate risk factorsNon-Hispanic white participantsQuality of lifeLong-term careCohort studyMultivariable analysisMean ageFunctional statusMAIN OUTCOMEPotential precipitantsDaily livingCohort Profile: The Precipitating Events Project (PEP Study)
Gill T, Han L, Gahbauer EA, Leo-Summers L, Murphy TE. Cohort Profile: The Precipitating Events Project (PEP Study). The Journal Of Nutrition Health & Aging 2020, 24: 438-444. PMID: 32242212, PMCID: PMC7322244, DOI: 10.1007/s12603-020-1341-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsPrecipitating Events ProjectPEP studyComprehensive home-based assessmentsEpidemiology of disabilityAge 70 yearsHealth care utilizationGreater New HavenLarge health planParticipant-level dataHome-based assessmentEnd of lifeCare utilizationDeath certificatesMedicare claimsDepressive symptomsOngoing longitudinal studyDisabling processEligible membersOlder personsHealth plansLongitudinal studyMethodologic researchCompletion ratesOriginal reportQualified investigators
2019
Increased Length of Stay Associated With Antibiotic Use in Older Adults With Advanced Cancer Transitioned to Comfort Measures
Datta R, Zhu M, Han L, Allore H, Quagliarello V, Juthani-Mehta M. Increased Length of Stay Associated With Antibiotic Use in Older Adults With Advanced Cancer Transitioned to Comfort Measures. American Journal Of Hospice And Palliative Medicine® 2019, 37: 27-33. PMID: 31185722, PMCID: PMC6868290, DOI: 10.1177/1049909119855617.Peer-Reviewed Original ResearchConceptsAdvanced cancerAntibiotic useComfort measuresPoisson regression modelsInfection diagnosisIntensive care unit admissionMultivariable Poisson regression modelsCare unit admissionCohort of patientsUrinary tract infectionGoal-concordant careUnit admissionEnd of lifeHospital lengthOlder patientsTract infectionsLonger LOSMedian ageRegression modelsStay AssociatedAntibiotic exposureLiquid tumorsPatientsCancerCancer typesAntimicrobial therapy for asymptomatic bacteriuria or candiduria in advanced cancer patients transitioning to comfort measures
Datta R, Wang T, Zhu M, Dembry LM, Han L, Allore H, Quagliarello V, Juthani-Mehta M. Antimicrobial therapy for asymptomatic bacteriuria or candiduria in advanced cancer patients transitioning to comfort measures. Infection Control And Hospital Epidemiology 2019, 40: 470-472. PMID: 30821230, PMCID: PMC6482377, DOI: 10.1017/ice.2019.22.Peer-Reviewed Original ResearchConceptsUrinary tract infectionIncidence rate ratiosAdvanced cancer patientsAsymptomatic bacteriuriaCancer patientsAntimicrobial therapySymptomatic urinary tract infectionPotential urinary tract infectionTract infectionsInappropriate therapyAntimicrobial daysComfort measuresBacteriuriaCandiduriaCFU/mLPatientsTherapyRate ratioMLInfection
2018
Diabetes, Heart Disease, and Dementia: National Estimates of Functional Disability Trajectories
Vroomen J, Han L, Monin JK, Lipska KJ, Allore HG. Diabetes, Heart Disease, and Dementia: National Estimates of Functional Disability Trajectories. Journal Of The American Geriatrics Society 2018, 66: 766-772. PMID: 29521414, PMCID: PMC5906138, DOI: 10.1111/jgs.15284.Peer-Reviewed Original ResearchConceptsHeart diseaseDisability trajectoriesPossible dementiaNational estimatesChronic conditionsGreater oddsPhysician-diagnosed chronic conditionsCognitive statusCommunity-dwelling Medicare beneficiariesMultiple chronic conditionsAging Trends StudyComplex survey designGroup-based trajectory modelingADL disabilityNational HealthProbable dementiaDaily livingMultinomial logistic regressionMedicare beneficiariesDiabetesStudy attritionConcurrent conditionsDementiaSociodemographic characteristicsSevere disability