2023
Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States
Leifheit E, Wang Y, Goldstein L, Lichtman J. Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States. PLOS ONE 2023, 18: e0292546. PMID: 37797070, PMCID: PMC10553827, DOI: 10.1371/journal.pone.0292546.Peer-Reviewed Original ResearchConceptsStroke hospitalization ratesMedicare beneficiariesIschemic strokeHospitalization ratesUS acute care hospitalsDual-eligible patientsLong-term mortalityUS Medicare beneficiariesIschemic stroke hospitalizationsPost-stroke outcomesAcute care hospitalsService Medicare beneficiariesDual-eligible statusDual-eligible beneficiariesPercentage of beneficiariesCause readmissionHigher readmissionClinical factorsDual eligibilityAdjusted analysisPoor outcomeStroke patientsCox regressionStroke hospitalizationsPrincipal diagnosisAssociation of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke
Wang Y, Leifheit E, Goldstein L, Lichtman J. Association of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke. PLOS ONE 2023, 18: e0289790. PMID: 37561680, PMCID: PMC10414659, DOI: 10.1371/journal.pone.0289790.Peer-Reviewed Original ResearchConceptsIschemic strokeInverse probability weightsStroke patientsCause mortalityOutcome metricsLower riskUS hospitalsBetter long-term outcomesRecurrent stroke rateIschemic stroke recurrenceIschemic stroke patientsLong-term outcomesUS Medicare beneficiariesPerformance categoriesIntermediate hospitalsRecurrent strokeStroke recurrenceCohort studyClinical factorsRecurrence ratePrincipal diagnosisPatient riskStroke rateReadmission measuresCox modelAssociations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke
Tran P, Warren J, Leifheit E, Goldstein L, Lichtman J. Associations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke. Stroke 2023, 54: e126-e129. PMID: 36729388, PMCID: PMC11059199, DOI: 10.1161/strokeaha.122.042265.Peer-Reviewed Original ResearchConceptsLong-term air pollutant exposureAir pollutant exposureCause hospital readmissionHospital readmissionPollutant exposureMedicare beneficiaries agePerformance categoriesMatter 2.5Sulfur dioxide exposureCause readmission measureIschemic strokeStroke incidenceUS patientsHospital characteristicsSD increaseReadmissionCox modelReadmission measuresBeneficiaries ageLong-term exposureStrokePatientsMedicaid ServicesParticulate matter 2.5US fee
2022
Trends in 1-Year Recurrent Ischemic Stroke in the US Medicare Fee-for-Service Population
Leifheit EC, Wang Y, Goldstein LB, Lichtman JH. Trends in 1-Year Recurrent Ischemic Stroke in the US Medicare Fee-for-Service Population. Stroke 2022, 53: 3338-3347. PMID: 36214126, PMCID: PMC11059192, DOI: 10.1161/strokeaha.122.039438.Peer-Reviewed Original ResearchConceptsRecurrent ischemic strokeIschemic strokeRecurrence rateMedicare beneficiariesRecurrent stroke rateSecondary stroke preventionPoor general healthHigh-risk populationHigh recurrence rateService Medicare beneficiariesUS Medicare feeHighest sextileRecurrent strokeStroke preventionStroke recurrenceClinical characteristicsCohort studyGeneral healthPrincipal diagnosisStroke rateUninsured adultsCox modelMedicare feeHigh recurrenceTesting ratesTrends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction
Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiology 2022, 7: 613-622. PMID: 35507330, PMCID: PMC9069341, DOI: 10.1001/jamacardio.2022.0662.Peer-Reviewed Original ResearchMeSH KeywordsAgedFee-for-Service PlansFemaleHospitalizationHumansMaleMedicareMyocardial InfarctionUnited StatesConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionHealth priority areasLong-term outcomesCause mortalityHazard ratioWhite patientsMyocardial infarctionMedicare feeMedicare-MedicaidService beneficiariesInitial acute myocardial infarctionTen-year mortalityShort-term outcomesDemographic subgroupsEligible patientsPatient characteristicsAMI survivorsAcute periodMean ageRecurrence rateSubgroup analysisMAIN OUTCOMEMortality riskAMI admissions
2021
Adherence to Acute Care Measures Affects Mortality in Patients with Ischemic Stroke: The Florida Stroke Registry
Gardener H, Rundek T, Lichtman J, Leifheit E, Wang K, Asdaghi N, Romano JG, Sacco RL. Adherence to Acute Care Measures Affects Mortality in Patients with Ischemic Stroke: The Florida Stroke Registry. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 105586. PMID: 33412397, PMCID: PMC7880890, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105586.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overFemaleFibrinolytic AgentsFloridaGuideline AdherenceHealthcare DisparitiesHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIschemic StrokeMaleMedicarePatient ReadmissionPractice Guidelines as TopicPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsRisk Reduction BehaviorSmoking CessationThrombolytic TherapyTime FactorsTreatment OutcomeUnited StatesConceptsAcute care measuresFlorida Stroke RegistryHospital readmissionCare measuresStatin therapyRace/ethnicityStroke RegistryAntithrombotic therapyIschemic strokeAntithrombotic useStroke careIntravenous alteplase treatmentMedicare beneficiaries ageAcute stroke careIschemic stroke patientsLong-term mortalityVascular risk factorsRace/ethnic disparitiesFull study populationAlteplase treatmentDVT prophylaxisEligible patientsAnticoagulation therapyCessation counselingStatin use
2020
Association Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction
Wang Y, Leifheit E, Normand S, Krumholz HM. Association Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction. Journal Of The American Heart Association 2020, 9: e014907. PMID: 32172654, PMCID: PMC7335517, DOI: 10.1161/jaha.119.014907.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionIndex acute myocardial infarctionClinical Classification SoftwareMyocardial infarctionDisease categoriesRisk of deathCox regression modelPost-acute careAcute care hospitalsOccurrence of hospitalizationLow recurrence riskUnplanned rehospitalizationSubsequent hospitalizationBackground PatientsHazard ratioPatient characteristicsSecondary preventionMedian timeService patientsChronic diseasesPatient riskOutcome measuresRehospitalizationHigh risk
2019
Race-Ethnic Disparities in 30-Day Readmission After Stroke Among Medicare Beneficiaries in the Florida Stroke Registry
Gardener H, Leifheit EC, Lichtman JH, Wang K, Wang Y, Gutierrez CM, Ciliberti-Vargas MA, Dong C, Robichaux M, Romano JG, Sacco RL, Rundek T, Investigators and Collaborators F. Race-Ethnic Disparities in 30-Day Readmission After Stroke Among Medicare Beneficiaries in the Florida Stroke Registry. Journal Of Stroke And Cerebrovascular Diseases 2019, 28: 104399. PMID: 31611168, PMCID: PMC6939298, DOI: 10.1016/j.jstrokecerebrovasdis.2019.104399.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack or African AmericanBrain IschemiaFemaleFloridaHealthcare DisparitiesHispanic or LatinoHumansInsurance BenefitsMaleMedicarePatient ReadmissionRecurrenceRegistriesRisk AssessmentRisk FactorsSecondary PreventionStrokeTime FactorsTransitional CareUnited StatesWhite PeopleConceptsFlorida Stroke RegistryAcute cerebrovascular eventsCause readmissionIschemic strokeRace/ethnicityStroke RegistryCerebrovascular eventsEthnic disparitiesCox proportional hazards modelTransient ischemic attackSecondary prevention strategiesUrinary tract infectionRace-ethnic disparitiesLength of stayProportional hazards modelIschemic attackFirst readmissionHospital dischargeTract infectionsArterial interventionsArtery interventionHemorrhagic strokeStroke patientsTransitional careThirty-day
2018
Racial/Ethnic Disparities in Mortality Among Medicare Beneficiaries in the FL‐PR CReSD Study
Gardener H, Leifheit EC, Lichtman JH, Wang Y, Wang K, Gutierrez CM, Ciliberti‐Vargas M, Dong C, Oluwole S, Robichaux M, Romano JG, Rundek T, Sacco RL, Investigators and Collaborators T. Racial/Ethnic Disparities in Mortality Among Medicare Beneficiaries in the FL‐PR CReSD Study. Journal Of The American Heart Association 2018, 8: e009649. PMID: 30587062, PMCID: PMC6405703, DOI: 10.1161/jaha.118.009649.Peer-Reviewed Original ResearchConceptsRacial/Ethnic DisparitiesQuality Improvement ProgramMedicare beneficiariesRace/ethnicityEthnic disparitiesBlack stroke patientsAcute stroke careElderly Medicare beneficiariesService Medicare beneficiariesHospital mortalityClinical characteristicsIschemic strokeStroke outcomeStroke careStroke patientsMixed logistic modelPrimary diagnosisHospitalReadmissionMortalityConclusions DisparitiesEthnic differencesE-SDOutcomesPatientsHospital Quality Metrics: “America's Best Hospitals” and Outcomes After Ischemic Stroke
Lichtman JH, Leifheit EC, Wang Y, Goldstein LB. Hospital Quality Metrics: “America's Best Hospitals” and Outcomes After Ischemic Stroke. Journal Of Stroke And Cerebrovascular Diseases 2018, 28: 430-434. PMID: 30415916, DOI: 10.1016/j.jstrokecerebrovasdis.2018.10.022.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaHospital Bed CapacityHospital MortalityHospitalsHospitals, High-VolumeHospitals, Low-VolumeHospitals, PrivateHospitals, RuralHospitals, TeachingHumansJoint Commission on Accreditation of Healthcare OrganizationsPatient ReadmissionPostoperative ComplicationsProcess Assessment, Health CareQuality Indicators, Health CareRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsTop-ranked hospitalsRisk-standardized mortalityHigher readmissionBest HospitalsIschemic strokeAmerica's Best HospitalsHospital-level careHospital Compare dataHospital quality metricsHospital volumeStroke measuresHospital characteristicsReadmissionBetter outcomesLower mortalityHospitalMortalityMedicaid ServicesOutcomesStrokeWorld ReportOutcomes after carotid endarterectomy among elderly dual Medicare-Medicaid-eligible patients.
Leifheit EC, Wang Y, Howard G, Howard VJ, Goldstein LB, Brott TG, Lichtman JH. Outcomes after carotid endarterectomy among elderly dual Medicare-Medicaid-eligible patients. Neurology 2018, 91: e1553-e1558. PMID: 30266891, PMCID: PMC6205687, DOI: 10.1212/wnl.0000000000006380.Peer-Reviewed Original ResearchConceptsCarotid endarterectomyDual-eligible patientsRelative annual reductionService Medicare beneficiariesDual-eligible statusYears of ageDual-eligible beneficiariesEligible patientsCause mortalityCause readmissionClinical characteristicsIschemic strokeAdjusted analysisStudy cohortWorse outcomesMedicaid coverageMedicare beneficiariesDual eligiblesPatientsMedicaid benefitsMedicare-MedicaidMedicareOutcomesEndarterectomyHigh rate
2017
Carotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014
Lichtman JH, Jones MR, Leifheit EC, Sheffet AJ, Howard G, Lal BK, Howard VJ, Wang Y, Curtis J, Brott TG. Carotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014. JAMA 2017, 318: 1035-1046. PMID: 28975306, PMCID: PMC5818799, DOI: 10.1001/jama.2017.12882.Peer-Reviewed Original ResearchConceptsVascular risk factorsCarotid endarterectomyCarotid arteryHospital mortalityCause mortalityRevascularization ratesIschemic strokeMyocardial infarctionRisk factorsMedicare beneficiariesSerial cross-sectional analysisUnderwent carotid arteryNumber of patientsUS national trendsService Medicare beneficiariesCross-sectional analysisSymptomatic patientsSymptomatic statusUnique patientsCarotid stenosisEndarterectomyMedicare inpatientMAIN OUTCOMEMedicare feePatientsAssociations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States
Pandolfi MM, Wang Y, Spenard A, Johnson F, Bonner A, Ho S, Elwell T, Bakullari A, Galusha D, Leifheit‐Limson E, Lichtman JH, Krumholz HM. Associations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States. International Journal Of Older People Nursing 2017, 12 PMID: 28516505, DOI: 10.1111/opn.12154.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission ratesHeart failureNursing homesService patientsMyocardial infarctionMedicare feeLower hospital readmission ratesHospital readmission ratesNurse staffing measuresAcute care hospitalsCross-sectional studyHospital service areasFive-Star Quality Rating SystemNursing home performanceUnplanned readmissionCare hospitalReadmission dataCommunity-based service providersCare teamMedicare patientsReadmissionStaffing measuresPatientsPneumoniaNational Trends and Geographic Variation in Availability of Home Health Care: 2002–2015
Wang Y, Leifheit‐Limson E, Fine J, Pandolfi MM, Gao Y, Liu F, Eckenrode S, Lichtman JH. National Trends and Geographic Variation in Availability of Home Health Care: 2002–2015. Journal Of The American Geriatrics Society 2017, 65: 1434-1440. PMID: 28322441, PMCID: PMC5507741, DOI: 10.1111/jgs.14811.Peer-Reviewed Original Research
2016
Average Temperature, Diurnal Temperature Variation, and Stroke Hospitalizations
Lichtman JH, Leifheit-Limson EC, Jones SB, Wang Y, Goldstein LB. Average Temperature, Diurnal Temperature Variation, and Stroke Hospitalizations. Journal Of Stroke And Cerebrovascular Diseases 2016, 25: 1489-1494. PMID: 27038980, DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.037.Peer-Reviewed Original Research
2015
Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction The VIRGO Study
Leifheit-Limson EC, D’Onofrio G, Daneshvar M, Geda M, Bueno H, Spertus JA, Krumholz HM, Lichtman JH. Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction The VIRGO Study. Journal Of The American College Of Cardiology 2015, 66: 1949-1957. PMID: 26515996, PMCID: PMC4628727, DOI: 10.1016/j.jacc.2015.08.859.Peer-Reviewed Original ResearchConceptsCardiac risk factorsAcute myocardial infarctionHealth care provider discussionsRisk modificationRisk factorsHeart diseaseHealth care providersProvider discussionsVIRGO StudyYounger patientsMyocardial infarctionCare providersSignificant cardiac risk factorsYoung AMI patientsPatients age 18Heart disease riskRisk factor prevalenceSelf-perceived riskModified Poisson regressionSex differencesFactor prevalenceAMI patientsCardiac riskSpanish hospitalsProvider feedbackCenters for Medicare and Medicaid Services Medicare Data and Stroke Research
Lichtman JH, Leifheit-Limson EC, Goldstein LB. Centers for Medicare and Medicaid Services Medicare Data and Stroke Research. Stroke 2015, 46: 598-604. PMID: 25593137, DOI: 10.1161/strokeaha.114.003255.Peer-Reviewed Original Research
2014
Depression as a Risk Factor for Poor Prognosis Among Patients With Acute Coronary Syndrome
Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, Freedland KE, Jaffe AS, Leifheit-Limson EC, Sheps DS, Vaccarino V, Wulsin L. Depression as a Risk Factor for Poor Prognosis Among Patients With Acute Coronary Syndrome. Circulation 2014, 129: 1350-1369. PMID: 24566200, DOI: 10.1161/cir.0000000000000019.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeCoronary syndromeAmerican Heart AssociationRisk factorsAdverse medical outcomesPoor prognosisHeart AssociationMedical outcomesAmerican Heart Association scientific statementScientific statementWriting group membersIndividual studiesMeasurement of depressionCardiac mortalityCause mortalityComposite outcomeNonfatal eventsProspective studyAdverse outcomesCardiac populationMultivariable modelInclusion criteriaPatientsSystematic reviewSyndrome
2013
Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®
Lichtman JH, Wang Y, Jones SB, Leifheit-Limson EC, Shaw LJ, Vaccarino V, Rumsfeld JS, Krumholz HM, Curtis JP. Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®. American Heart Journal 2013, 167: 376-383. PMID: 24576523, DOI: 10.1016/j.ahj.2013.11.001.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionComplication rateOlder womenPCI typeYoung womenInhospital mortalityMortality riskAge groupsElective percutaneous coronary interventionPercutaneous coronary intervention (PCI) proceduresInhospital complication rateRate of complicationsHigh complication rateRisk-adjusted analysisRisk-adjusted mortalityCoronary intervention proceduresUnadjusted complication rateSex-based differencesPCI patientsCathPCI RegistryCoronary interventionYounger patientsClinical factorsHospital admissionMore complicationsPreventable Readmissions Within 30 Days of Ischemic Stroke Among Medicare Beneficiaries
Lichtman JH, Leifheit-Limson EC, Jones SB, Wang Y, Goldstein LB. Preventable Readmissions Within 30 Days of Ischemic Stroke Among Medicare Beneficiaries. Stroke 2013, 44: 3429-3435. PMID: 24172581, PMCID: PMC3905749, DOI: 10.1161/strokeaha.113.003165.Peer-Reviewed Original ResearchConceptsPreventable readmission ratesIschemic strokePrevention Quality IndicatorsPreventable readmissionsReadmission ratesHealthcare ResearchQuality's Prevention Quality IndicatorsHospital Inpatient Quality Reporting ProgramCauses of readmissionThirty-day readmissionHigh-risk patientsPatient-level factorsRandom effects logistic regressionIschemic stroke dischargesQuality Reporting ProgramCause readmissionHospital readmissionComorbid conditionsPreventable causePrimary diagnosisReadmissionMedicare feeMedicare beneficiariesService beneficiariesMultivariate analysis