BACKGROUND: With recent legislation imposing penalties on hospitals for above-average 30-day all-cause readmissions for patients with acute decompensated heart failure (ADHF), there is concern these penalties will more heavily impact hospitals serving socioeconomically vulnerable and underserved populations. HYPOTHESIS: Patients with ADHF and low socioeconomic status have better postdischarge mortality and readmission outcomes when cardiologists are involved in their in-hospital care. METHODS: We retrospectively searched the electronic medical record for patients hospitalized for ADHF from 2001 to 2010 in 3 urban hospitals within a large university-based health system. These patients were divided into 2 groups based on whether a cardiologist was involved in their care or not. Measured outcomes were 30- and 60-day postdischarge mortality and readmission rates. RESULTS: Out of the 7516 ADHF patients, 1434 patients were seen by a cardiologist (19%). These patients had lower 60-day mortality (5.4% vs 7.0%; hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.52-0.96, P = 0.034) and lower 30- and 60-day readmission rates (16.7% vs 20.6%; HR: 0.76, 95% CI: 0.66-0.89, P = 0.002, and 26.1% vs 30.2%; HR: 0.81, 95% CI: 0.72-0.92, P = 0.003, respectively). There was no significant difference in the in-hospital mortality between the 2 groups. Compared with other races, whites with systolic HF have marginally lower HF-related readmission rates when treated by cardiologists. CONCLUSIONS: In this cohort of ADHF patients from the Bronx, New York, involvement of a cardiologist resulted in improved short-term mortality and readmission outcomes compared with treatment by general internal medicine.
BACKGROUND: With recent legislation imposing penalties on hospitals for above-average 30-day all-cause readmissions for patients with acute decompensated heart failure (ADHF), there is concern these penalties will more heavily impact hospitals serving socioeconomically vulnerable and underserved populations. HYPOTHESIS: Patients with ADHF and low socioeconomic status have better postdischarge mortality and readmission outcomes when cardiologists are involved in their in-hospital care. METHODS: We retrospectively searched the electronic medical record for patients hospitalized for ADHF from 2001 to 2010 in 3 urban hospitals within a large university-based health system. These patients were divided into 2 groups based on whether a cardiologist was involved in their care or not. Measured outcomes were 30- and 60-day postdischarge mortality and readmission rates. RESULTS: Out of the 7516 ADHF patients, 1434 patients were seen by a cardiologist (19%). These patients had lower 60-day mortality (5.4% vs 7.0%; hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.52-0.96, P = 0.034) and lower 30- and 60-day readmission rates (16.7% vs 20.6%; HR: 0.76, 95% CI: 0.66-0.89, P = 0.002, and 26.1% vs 30.2%; HR: 0.81, 95% CI: 0.72-0.92, P = 0.003, respectively). There was no significant difference in the in-hospital mortality between the 2 groups. Compared with other races, whites with systolic HF have marginally lower HF-related readmission rates when treated by cardiologists. CONCLUSIONS: In this cohort of ADHF patients from the Bronx, New York, involvement of a cardiologist resulted in improved short-term mortality and readmission outcomes compared with treatment by general internal medicine.
Authors: Alexander C Perino; Jun Fan; Susan K Schmitt; Mariam Askari; Daniel W Kaiser; Abhishek Deshmukh; Paul A Heidenreich; Christopher Swan; Sanjiv M Narayan; Paul J Wang; Mintu P Turakhia Journal: J Am Coll Cardiol Date: 2017-07-04 Impact factor: 24.094
Authors: Khadijah Breathett; Wenhui G Liu; Larry A Allen; Stacie L Daugherty; Irene V Blair; Jacqueline Jones; Gary K Grunwald; Marc Moss; Tyree H Kiser; Ellen Burnham; R William Vandivier; Brendan J Clark; Eldrin F Lewis; Sula Mazimba; Catherine Battaglia; P Michael Ho; Pamela N Peterson Journal: JACC Heart Fail Date: 2018-05 Impact factor: 12.035
Authors: Kenneth E Freedland; Robert M Carney; Michael W Rich; Brian C Steinmeyer; Judith A Skala; Victor G Dávila-Román Journal: Clin Cardiol Date: 2016-02-03 Impact factor: 2.882
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: Jacopo Lenzi; Vera Maria Avaldi; Dario Molinazzi; Carlo Descovich; Stefano Urbinati; Veronica Cappelli; Maria Pia Fantini Journal: PLoS One Date: 2019-10-28 Impact factor: 3.240
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