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 ResearchConceptsRecurrent 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 admissionsCardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study
Chang TE, Goldstein LB, Leifheit EC, Howard VJ, Lichtman JH. Cardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study. Journal Of Women's Health 2022, 31: 834-841. PMID: 35148481, DOI: 10.1089/jwh.2021.0471.Peer-Reviewed Original ResearchConceptsStroke/transient ischemic attackTransient ischemic attackPrior stroke/transient ischemic attackCause ED visitsEmergency department visitsHealth care utilizationCross-sectional studyCause hospitalizationED visitsIschemic attackDepartment visitsCare utilizationCVD-RFsCardiovascular risk factor profileCardiovascular disease risk factorsCovariate-adjusted logistic regression modelsCause emergency department visitsHigher health care utilizationMedical Expenditure Panel Survey dataRisk factor profileDisease risk factorsHistory of strokeOdds of hospitalizationRepresentative Medical Expenditure Panel Survey dataSex-specific predictors
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-SDOutcomesPatientsOutcomes 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 measuresPatientsPneumonia
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
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 analysisPrevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race
Leifheit-Limson EC, Spertus JA, Reid KJ, Jones SB, Vaccarino V, Krumholz HM, Lichtman JH. Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race. Journal Of Women's Health 2013, 22: 659-666. PMID: 23841468, DOI: 10.1089/jwh.2012.3962.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overBlack or African AmericanBody Mass IndexCounselingDiabetes Mellitus, Type 2FemaleHospitalizationHumansHypercholesterolemiaHypertensionLife StyleMaleMiddle AgedMyocardial InfarctionObesityPrevalenceProspective StudiesRisk FactorsSecondary PreventionSex FactorsSmokingSmoking CessationSocioeconomic FactorsWhite PeopleConceptsCardiac risk factorsAcute myocardial infarctionSecondary prevention effortsTraditional cardiac risk factorsLipid-lowering medicationsRisk factorsWhite patientsAMI patientsMyocardial infarctionPrevention effortsGreater risk factor burdenMultiple cardiac risk factorsRisk factor burdenYoung black patientsYoung white patientsSecondary prevention strategiesRisk factor prevalenceHigh-risk subgroupsMultiple risk factorsBlack womenAge-sex groupsOlder patientsSecondary preventionYounger patientsFactor prevalence
2012
30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals
Lichtman JH, Leifheit-Limson EC, Jones SB, Wang Y, Goldstein LB. 30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals. Stroke 2012, 43: 2741-2747. PMID: 22935397, PMCID: PMC3547601, DOI: 10.1161/strokeaha.112.665646.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesRisk-standardized readmission ratesAnnual hospital volumeIschemic strokeReadmission ratesHospital volumeVolume quartileHighest risk-standardized mortality ratesPoor short-term outcomeMedicare beneficiaries 65 yearsService Medicare beneficiaries 65 yearsHighest volume quartileHospital volume quartilesPrimary discharge diagnosisLow-volume hospitalsShort-term outcomesBeneficiaries 65 yearsChanges in social support within the early recovery period and outcomes after acute myocardial infarction
Leifheit-Limson EC, Reid KJ, Kasl SV, Lin H, Buchanan DM, Jones PG, Peterson PN, Parashar S, Spertus JA, Lichtman JH. Changes in social support within the early recovery period and outcomes after acute myocardial infarction. Journal Of Psychosomatic Research 2012, 73: 35-41. PMID: 22691557, PMCID: PMC3374926, DOI: 10.1016/j.jpsychores.2012.04.006.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDisease-specific qualityDepressive symptomsMyocardial infarctionEarly recoveryGeneral mental functioningLower disease-specific qualitySocial supportRisk-adjusted analysisBaseline depressive symptomsEarly recovery periodMore depressive symptomsRepeated-measures regressionFirst yearMental functioningBaseline outcome levelsClinical factorsAMI patientsPoor outcomeProspective studyBetter outcomesHealth statusPatientsSociodemographic characteristicsGreater risk
2011
Adherence to Risk Factor Management Instructions after Acute Myocardial Infarction: The Role of Emotional Support and Depressive Symptoms
Leifheit-Limson EC, Kasl SV, Lin H, Buchanan DM, Peterson PN, Spertus JA, Lichtman JH. Adherence to Risk Factor Management Instructions after Acute Myocardial Infarction: The Role of Emotional Support and Depressive Symptoms. Annals Of Behavioral Medicine 2011, 43: 198-207. PMID: 22037964, PMCID: PMC3374717, DOI: 10.1007/s12160-011-9311-z.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPoor adherenceMyocardial infarctionManagement adherenceDepressive symptomsNon-depressed patientsEmotional supportLow emotional supportClinical factorsAMI patientsStratified analysisMixed-effects regressionBaseline supportPatientsGreater riskLongitudinal associationsAdherenceSignificant predictorsInfarctionSymptomsFirst yearFurther investigationAssociationDepressionSignificant relationship
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