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
“Phenotyping” Hospital Value of Care for Patients with Heart Failure
Xu X, Li S, Lin H, Normand S, Kim N, Ott LS, Lagu T, Duan M, Kroch EA, Krumholz HM. “Phenotyping” Hospital Value of Care for Patients with Heart Failure. Health Services Research 2014, 49: 2000-2016. PMID: 24974769, PMCID: PMC4254136, DOI: 10.1111/1475-6773.12197.Peer-Reviewed Original ResearchConceptsLower mortalityHeart failureHeart failure hospitalizationHospital mortality rateLonger hospital stayIntensive care unitDistinct joint trajectoriesValue of careFailure hospitalizationHospital stayCare unitClinical outcomesGroup of hospitalsHospital characteristicsHospital careHospital patternsSurgical proceduresMultinomial logistic regressionMortality rateHigh mortalityHospitalHospitalizationMortalityLogistic regressionHospital ValueHospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartile
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 timeHOSPITAL PRACTICE PATTERNS IN NONINVASIVE POSITIVE PRESSURE VENTILATION USE AMONG PATIENTS WITH ACUTE HEART FAILURE
Kulkarni V, Kim N, Dai Y, Dharmarajan K, Bikdeli B, Safavi K, Krumholz H. HOSPITAL PRACTICE PATTERNS IN NONINVASIVE POSITIVE PRESSURE VENTILATION USE AMONG PATIENTS WITH ACUTE HEART FAILURE. Journal Of The American College Of Cardiology 2013, 61: e1544. DOI: 10.1016/s0735-1097(13)61544-2.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
2012
Procedure Intensity and the Cost of Care
Chen SI, Dharmarajan K, Kim N, Strait KM, Li SX, Safavi KC, Lindenauer PK, Krumholz HM, Lagu T. Procedure Intensity and the Cost of Care. Circulation Cardiovascular Quality And Outcomes 2012, 5: 308-313. PMID: 22576844, PMCID: PMC3415230, DOI: 10.1161/circoutcomes.112.966069.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCosts and Cost AnalysisCross-Sectional StudiesFemaleHeart FailureHospital Bed CapacityHospital CostsHospital MortalityHospitalizationHospitals, RuralHospitals, TeachingHospitals, UrbanHumansLength of StayLinear ModelsMaleMiddle AgedModels, EconomicOutcome and Process Assessment, Health CareResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsHF hospitalizationHeart failureInvasive proceduresHospital groupRisk-standardized mortality ratesProportion of patientsLength of stayCost of careWilcoxon rank sum testHigher procedure ratesRank sum testPatient demographicsPerspective databaseMedian lengthSurgical proceduresProcedure ratesHospitalizationOutcome differencesMortality rateHospitalPatientsPractice styleProcedure useSum testOverall use