A5070107914- Heart Failure Treatment and Management
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- Atrial Fibrillation Management and Outcomes
- Cardiac pacing and defibrillation studies
- Cardiovascular Function and Risk Factors
- Cardiac Arrhythmias and Treatments
- Medication Adherence and Compliance
- Mechanical Circulatory Support Devices
- Antiplatelet Therapy and Cardiovascular Diseases
- Cardiac Arrest and Resuscitation
- Pharmaceutical Practices and Patient Outcomes
- Emergency and Acute Care Studies
- Blood Pressure and Hypertension Studies
- Chronic Disease Management Strategies
- Cardiac Structural Anomalies and Repair
- Health disparities and outcomes
- Advanced Causal Inference Techniques
- Acute Myocardial Infarction Research
- Cardiac electrophysiology and arrhythmias
- Statistical Methods in Clinical Trials
- Potassium and Related Disorders
- Retinal Imaging and Analysis
- Geriatric Care and Nursing Homes
- Cardiac, Anesthesia and Surgical Outcomes
Duke University
2016-2025
Clinical Research Institute
2016-2025
University of North Carolina at Chapel Hill
2024
iRhythm (United States)
2024
Duke University Health System
2020-2023
Duke Medical Center
2006-2020
University of California Davis Medical Center
2019
Duke University Hospital
2006-2019
Bradley Hospital
2011-2018
University of Michigan
2014-2017
Readmission after hospitalization for heart failure is common. Early outpatient follow-up has been proposed as a means of reducing readmission rates. However, there are limited data describing patterns and its association with rates.To examine associations between within 7 days discharge from 30 days.Observational analysis patients 65 years or older discharged to home hospitals participating in the Organized Program Initiate Lifesaving Treatment Hospitalized Patients With Heart Failure Get...
Background— Atrial fibrillation (AF) is a common and costly problem among older persons. The frequency of AF increases with age, but representative national data about incidence prevalence are limited. We examined the annual incidence, prevalence, mortality associated Methods Results— In retrospective cohort study Medicare beneficiaries 65 years diagnosed between 1993 2007, we measured age- sex-adjusted following an diagnosis. Among 433 123 patients incident AF, mean age was 80 years, 55%...
For patients with coronary heart disease, exercise-based cardiac rehabilitation improves survival rate and has beneficial effects on risk factors for artery disease. The relationship between the number of sessions attended long-term outcomes is unknown.In a national 5% sample Medicare beneficiaries, we identified 30 161 elderly who at least 1 session January 1, 2000, December 31, 2005. We used Cox proportional hazards model to estimate death myocardial infarction (MI) 4 years. cumulative was...
Studies have examined the use of evidence-based therapies for coronary artery disease (CAD) in short term and at hospital discharge, but few evaluated long-term use.Using Duke Databank Cardiovascular Disease years 1995 to 2002, we determined annual prevalence consistency self-reported aspirin, beta-blockers, lipid-lowering agents, their combinations all CAD patients angiotensin-converting enzyme inhibitors (ACEIs) those with without heart failure. Logistic-regression models identified...
Inverse probability-weighted estimation is a powerful tool for use with observational data. In this article, we describe how propensity score-based method can be used to compare the effectiveness of 2 or more treatments. First, discuss inherent problems in using data assess comparative effectiveness. Next, provide conceptual explanation inverse and point readers sources that address formal, technical terms. Finally, offer detailed guidance about implement estimators analyses.
The appropriate dose of aspirin to lower the risk death, myocardial infarction, and stroke minimize major bleeding in patients with established atherosclerotic cardiovascular disease is a subject controversy.Using an open-label, pragmatic design, we randomly assigned strategy 81 mg or 325 per day. primary effectiveness outcome was composite death from any cause, hospitalization for stroke, assessed time-to-event analysis. safety bleeding, also analysis.A total 15,076 were followed median...
Previous studies of sex differences in the use implantable cardioverter-defibrillators (ICDs) predate recent expansions Medicare coverage and did not provide patient follow-up over multiple years.To examine ICD for primary secondary prevention sudden cardiac death.Analysis a 5% national sample research-identifiable files obtained from US Centers & Medicaid Services period 1991 through 2005. Patients were those aged 65 years or older with fee-for-service diagnosed acute myocardial infarction...
Changes in the demographics and epidemiology of patients with cardiovascular comorbidities who undergo major noncardiac surgery require an updated assessment which are at greater risk mortality or readmission. The authors evaluated short-term outcomes among heart failure, coronary artery disease (CAD), neither underwent surgery.Patients were aged 65 older, had Medicare fee-for-service coverage, 1 13 procedures from 2000 through 2004, excluding end-stage renal did not have least yr...
The treatment of chronic heart failure has improved during the past 2 decades, but little is known about whether improvements are reflected in trends early and long-term mortality hospital readmission.In a retrospective cohort study 540 838 elderly Medicare beneficiaries hospitalized with between January 1, 2001, December 31, 2005, we examined all-cause readmission patient- hospital-level predictors these outcomes.Unadjusted in-hospital declined from 5.1% to 4.2% (P < .001), 30-day, 180-day,...
Background: The increase in medical complexity among patients hospitalized with heart failure (HF) may be reflected by an concomitant noncardiovascular comorbidities. Among HF, the temporal trends prevalence of comorbidities have not been well described. Methods and Results: We used data from 207 984 Get With Guidelines–Heart Failure registry (from 2005 to 2014) evaluate (chronic obstructive pulmonary disorder/asthma, anemia, diabetes mellitus, obesity [body mass index ≥30 kg/m 2 ], renal...
Little is known about the long-term outcomes in elderly survivors of in-hospital cardiac arrest. We determined rates survival and readmission among arrest examined whether these differed according to demographic characteristics neurologic status at discharge.We linked data from a national registry inpatient arrests with Medicare files identified 6972 adults, 65 years age or older, who were discharged hospital after surviving an between 2000 2008. Predictors 1-year examined.One year...
Background— Atrial fibrillation is common among older persons. Catheter ablation increasingly used in patients for whom medical therapy has failed. Methods and Results— We conducted a retrospective cohort study of all fee-for-service Medicare beneficiaries ≥65 years age who underwent catheter atrial between July 1, 2007, December 31, 2009. The main outcome measures were major complications within 30 days mortality, heart failure, stroke, hospitalization, repeat 1 year. A total 15 423...
URING THE PAST 30 YEARS, large randomized trials have established the efficacy of multiple therapies for reducing mortality among patients with heart failure and reduced ejection fraction. 1Among most efficacious are aldosterone antagonists spironolactone eplerenone.In 2 landmark trials, these agents by 24% to 30% readmission nearly 40%. 2,3Despite findings subsequent class I guideline recommendations, use antagonist therapy remains lower than expected. 1,4,5low varied adoption in clinical...
Background— Reducing 30-day heart failure readmission rates is a national priority. Yet, little known about how hospitals address the problem and whether hospital-based processes of care are associated with reductions in rates. Methods Results— We surveyed 100 randomly selected participating Get With Guidelines-Heart Failure quality improvement program regarding common aimed at reducing readmissions. grouped into 3 domains (ie, inpatient care, discharge transitional general improvement)...
Introduction: Distributed research networks (DRNs) are critical components of the strategic roadmaps for National Institutes Health and Food Drug Administration as they work to move toward large-scale systems evidence generation. The Patient-Centered Clinical Research Network (PCORnet®) is one first DRNs incorporate electronic health record data from multiple domains on a national scale. Before conducting analyses in DRN, it important assess quality characteristics data.Methods: PCORnet’s...