BACKGROUND: Whether specialty care improves survival among patients with heart failure remains controversial. METHODS: We evaluated specialty care and outcomes in 25869 Medicare beneficiaries hospitalized with heart failure in the United States from 1998 through 1999. Patients were classified based on the specialty of their attending physician: cardiologist, internist, general physician, or family physician. The primary outcome of interest was all-cause mortality within 30 days of admission. RESULTS: Cardiologists were attending physicians for 26%, internists for 50%, and general and family physicians cared for the remainder. Mortality at 30 days was lowest for patients cared for by cardiologists (8.8%), higher for patients cared for by internists (10.0%, relative risk [RR] = 1.07; 95% confidence interval [CI]: 0.97 to 1.19; P = 0.059) and general physicians (11.1%, RR = 1.26; 95% CI: 0.99 to 1.58; P = 0.086), and highest for patients cared for by family physicians (12.0%, RR = 1.31; 95% CI: 1.15 to 1.49; P <0.001). Patients cared for by family physicians remained at higher 30-day mortality rates whether with (RR = 1.30; 95% CI: 1.11 to 1.52) or without consultation with cardiologists (RR = 1.31; 95% CI: 1.13 to 1.52). CONCLUSION: Hospitalized patients with heart failure had lower 30-day mortality when treated by cardiologists than when they were treated by other physicians. Although these differences were modest (RR = 1.07) for internists, they were substantial for general physicians (RR = 1.26) and family physicians (RR = 1.31); of note was that inpatient cardiology consultation did not appear to change this relation.
BACKGROUND: Whether specialty care improves survival among patients with heart failure remains controversial. METHODS: We evaluated specialty care and outcomes in 25869 Medicare beneficiaries hospitalized with heart failure in the United States from 1998 through 1999. Patients were classified based on the specialty of their attending physician: cardiologist, internist, general physician, or family physician. The primary outcome of interest was all-cause mortality within 30 days of admission. RESULTS: Cardiologists were attending physicians for 26%, internists for 50%, and general and family physicians cared for the remainder. Mortality at 30 days was lowest for patients cared for by cardiologists (8.8%), higher for patients cared for by internists (10.0%, relative risk [RR] = 1.07; 95% confidence interval [CI]: 0.97 to 1.19; P = 0.059) and general physicians (11.1%, RR = 1.26; 95% CI: 0.99 to 1.58; P = 0.086), and highest for patients cared for by family physicians (12.0%, RR = 1.31; 95% CI: 1.15 to 1.49; P <0.001). Patients cared for by family physicians remained at higher 30-day mortality rates whether with (RR = 1.30; 95% CI: 1.11 to 1.52) or without consultation with cardiologists (RR = 1.31; 95% CI: 1.13 to 1.52). CONCLUSION: Hospitalized patients with heart failure had lower 30-day mortality when treated by cardiologists than when they were treated by other physicians. Although these differences were modest (RR = 1.07) for internists, they were substantial for general physicians (RR = 1.26) and family physicians (RR = 1.31); of note was that inpatient cardiology consultation did not appear to change this relation.
Authors: Brian M Salata; Madeline R Sterling; Ashley N Beecy; Ajayram V Ullal; Erica C Jones; Evelyn M Horn; Parag Goyal Journal: Am J Cardiol Date: 2018-02-07 Impact factor: 2.778
Authors: Lauren A Eberly; Aaron Richterman; Anne G Beckett; Bram Wispelwey; Regan H Marsh; Emily C Cleveland Manchanda; Cindy Y Chang; Robert J Glynn; Katherine C Brooks; Robert Boxer; Rose Kakoza; Jennifer Goldsmith; Joseph Loscalzo; Michelle Morse; Eldrin F Lewis; Samantha Abel; Ayrenne Adams; Joseph Anaya; Erik H Andrews; Benjamin Atkinson; Viswatej Avutu; Alexandra Bachorik; Omar Badri; Mariel Bailey; Katie Baird; Salina Bakshi; Denis Balaban; Kenneth Barshop; Emily Baumrin; Omar Bayomy; Julia Beamesderfer; Nora Becker; David D Berg; Adam N Berman; Steven M Blum; Alexander P Boardman; Kaeleen Boden; Robert A Bonacci; Sarah Brown; Kirsti Campbell; Siobhan Case; Emily Cetrone; Alexandra Charrow; David Chiang; Devin Clark; Aaron J Cohen; Alissa Cooper; Tomas Cordova; C Nicholas Cuneo; Alsina Alejandro de Feria; Karen Deffenbacher; Ersilia M DeFilippis; Geneva DeGregorio; Aaron J Deutsch; Bradford Diephuis; Sanjay Divakaran; Peter Dorschner; Nicholas Downing; Caitlin Drescher; Kristin M D'Silva; Peter Dunbar; David Duong; Sarah Earp; Christine Eckhardt; Scott A Elman; Ross England; Kay Everett; Natalie Fedotova; Tamara Feingold-Link; Mark Ferreira; Herrick Fisher; Patricia Foo; Michael Foote; Idalid Franco; Thomas Gilliland; Jacqueline Greb; Katherine Greco; Sungat Grewal; Benjamin Grin; Matthew E Growdon; Brendan Guercio; Cynthia K Hahn; Brian Hasselfeld; Erika J Haydu; Zachary Hermes; Gordon Hildick-Smith; Zachary Holcomb; Kathryn Holroyd; Laura Horton; George Huang; Stanley Jablonski; Douglas Jacobs; Nina Jain; Sohan Japa; Richard Joseph; Mariya Kalashnikova; Neil Kalwani; Daniel Kang; Abraar Karan; Joel T Katz; Daniel Kellner; Khameer Kidia; June-Ho Kim; Scott M Knowles; Laura Kolbe; Idil Kore; Yiannis Koullias; Ifedayo Kuye; Joshua Lang; Matthew Lawlor; Melissa G Lechner; Ken Lee; Scott Lee; Zachary Lee; Neha Limaye; Stephanie Lin-Beckford; Marla Lipsyc; Jessica Little; Julia Loewenthal; Ranjani Logaraj; Diana M Lopez; Daniel Loriaux; Yi Lu; Kevin Ma; Nareh Marukian; Wilfredo Matias; Jared R Mayers; Ian McConnell; Michael McLaughlin; Christina Meade; Catherine Meador; Anish Mehta; Elizabeth Messenger; Constantinos Michaelidis; Jacob Mirsky; Emilie Mitten; Alisa Mueller; Jyotsna Mullur; Amir Munir; Emily Murphy; Ellen Nagami; Abirami Natarajan; Michelle Nsahlai; Chijioke Nze; Noreen Okwara; Peter Olds; Rafael Paez; Michael Pardo; Siddharth Patel; Alec Petersen; Laura Phelan; Erica Pimenta; Daniel Pipilas; Molly Plovanich; Denise Pong; Brian W Powers; Anita Rao; Haiyan Ramirez Batlle; Mattheus Ramsis; Anna Reichardt; Sheridan Reiger; Michelle Rengarajan; Stephanie Rico; Benjamin N Rome; Rachael Rosales; Lisa Rotenstein; Alexis Roy; Sarah Royston; Hallie Rozansky; Meghan Rudder; Christine E Ryan; Sanjay Salgado; Pablo Sanchez; Jennifer Schulte; Aswin Sekar; Nicholas Semenkovich; Evan Shannon; Neil Shaw; Andrew Ben Shorten; William Shrauner; Lauren Sinnenberg; James W Smithy; Gregory Snyder; Anirudh Sreekrishnan; Hans Stabenau; Eleni Stavrou; Andrew Stergachis; Robert Stern; Alexander Stone; Shervin Tabrizi; Sam Tanyos; Cristina Thomas; Haley Thun; Kristine Torres-Lockhart; An Tran; Carolyn Treasure; Frederick D Tsai; Stephen Tsaur; Evan Tschirhart; Justin Tuwatananurak; Ramkumar V Venkateswaran; Anastasia Vishnevetsky; Lindsay Wahl; April Wall; Frances Wallace; Elisa Walsh; Priscilla Wang; Heather B Ward; Lindsay N Warner; Lachelle D Weeks; Kipp Weiskopf; Jordan Wengrod; Jessica N Williams; Marisa Winkler; Jeffrey L Wong; Devin Worster; Aileen Wright; Caroline Wunsch; Jamila S Wynter; Chase Yarbrough; Wai-Ying Yau; Daniel Yazdi; Jennifer Yeh; Maria A Yialamas; Nicholas Yozamp; Marina Zambrotta; Rebecca Zon Journal: Circ Heart Fail Date: 2019-10-29 Impact factor: 8.790
Authors: Michael J Diamant; Sean A Virani; Winston J MacKenzie; Andrew Ignaszewski; Mustafa Toma; Nathaniel M Hawkins Journal: ESC Heart Fail Date: 2019-06-20
Authors: Emil L Fosbol; DaJuanicia N Holmes; Jonathan P Piccini; Laine Thomas; James A Reiffel; Roger M Mills; Peter Kowey; Kenneth Mahaffey; Bernard J Gersh; Eric D Peterson Journal: J Am Heart Assoc Date: 2013-07-18 Impact factor: 5.501
Authors: Vera Maria Avaldi; Jacopo Lenzi; Stefano Urbinati; Dario Molinazzi; Carlo Descovich; Anselmo Campagna; Martina Taglioni; Angelo Fioritti; Maria Pia Fantini Journal: BMJ Open Date: 2017-11-03 Impact factor: 2.692