134 research outputs found
Trends in hospitalizations among medicare survivors of aortic valve replacement in the United States from 1999 to 2010
No full textAbstract not availableKarthik Murugiah, Yun Wang, John A. Dodson, Sudhakar V. Nuti, Kumar Dharmarajan, Isuru Ranasinghe, Zack Cooper, Harlan M. Krumhol
Most important outcomes research papers on device therapies for cardiomyopathies
No full textAakriti Gupta, Kumar Dharmarajan, Rachel Dreyer, Behnood Bikdeli, Ruijun Chen, Vivek T. Kulkarni, Ruizhi Shi, Abbas Shojaee, Isuru Ranasinghe for The Edito
Falling cholesterol trend at acute coronary syndrome presentation is strongly related to statin use for secondary prevention
No full textAbstract not availableThomas Chan, Bilyana Dabin, Karice Hyun, Isuru Ranasinghe, Lis Neubeck, Bernadette Aliprandi-Costa, Jeffrey Lefkovits, Gerard Devlin, Craig Juergens, Derek P. Chewh, David Brieger, S. Ben Freedma
Most important outcomes research papers on body weight, obesity and cardiovascular outcomes
No full textThe following are highlights from the new series, Circulation: Cardiovascular Quality and Outcomes Topic Review. This series will summarize the most important manuscripts, as selected by the Editor, that have published in the Circulation portfolio. The objective of this new series
is to provide our readership with a timely, comprehensive selection of important papers that are relevant to the quality and outcomes, and
general cardiology audience. The studies included in this article represent the most significant research related to body weight and obesity.Ruijun Chen, Purav S. Mody, Aakriti Gupta, Behnood Bikdeli, Rachel Dreyer, Serene I. Chen, Sudhakar Nuti and Isuru Ranasinghe for the edito
Most important outcomes research papers on hypertension
No full textThe following are highlights from the new series, Circulation: Cardiovascular Quality and Outcomes Topic Review. This series will summarize the most important manuscripts, as selected by the Editor, which have published in the Circulation portfolio. The objective of this new series is to provide our readership with a timely, comprehensive selection of important papers that are relevant to the quality and outcomes, as well as general cardiology audience. The studies included in this article represent the most significant research related to hypertension.Ruijun Chen, Kumar Dharmarajan, Vivek T. Kulkarni, Natdanai Punnanithinont, Aakriti Gupta,Behnood Bikdeli, Purav S. Mody, and Isuru Ranasinghe for the Edito
Long-term outcomes of patients with acute myocardial infarction presenting to regional and remote hospitals
No full textBackground: Acute myocardial infarction (AMI) has poorer outcomes in disadvantaged populations such as those in regional and remote locations. We compared long-term outcomes associated with presentation to regional or remote hospitals among AMI patients. Methods
and Results: Administrative claims data from New South Wales (27% regional and remote residents) was used to identify patients >18 years admitted to any NSW hospital with a principal diagnosis of AMI (ICD10 codes: I21·0-I21·4) between 01/07/2004 and 30/06/2008. Hospital of presentation location with a population of 250,000 were deemed urban. Receipt of revascularisation and mortality were analysed and adjusted for age, comorbidities and previous revascularisation. Patients were censored at death or end of the follow-up period (31 December 2009). 39,798 patients were identified with 9,393 (23.6%) regional and remote presenters. In multivariable models, regional and remote presentation was associated with reduced rates of revascularisation (OR 0.30 95%CI 0.28-0.32; p<0.001), no impact on overall mortality (HR 1.04 95%CI 0.99-1.02; p=0.11), but with increased mortality for patients presenting with STEMI (HR 1.14; 95% CI 1.06-1.23; p<0.001). The propensity analysis was consistent with these findings. Conclusions: Presentation to a regional and remote hospital was associated with lower revascularisation rates following AMI, but with a higher long-term mortality if presenting with ST segment elevation.Sradha Kotwal, Isuru Ranasinghe, David Brieger, Philip Clayton, Alan Cass, Martin Gallaghe
Hospital-based acute care after outpatient colonoscopy: implications for quality measurement in the ambulatory setting
No full textIntroduction: Ambulatory surgery centers now report immediate hospital transfer rates as a measure of quality. For patients undergoing colonoscopy, this measure may fail to capture adverse events, which occur after discharge yet still require a hospital-based acute care encounter. Objective: We conducted this study to estimate rates of immediate hospital transfer and hospital-based acute care following outpatient colonoscopy performed in ambulatory surgery centers. Research Design and Subjects: Using state ambulatory surgery databases from the 2009–2010 Healthcare Cost and Utilization Project, we identified adult patients who underwent colonoscopy. Immediate hospital transfer and overall acute health care utilization in the 14 days following colonoscopy was determined from corresponding inpatient, ambulatory surgery, and emergency department databases. To compare rates across centers while accounting for differences in patient populations, we calculated risk-standardized rates using hierarchical generalized linear modeling. Results: The final sample included 1,137,381 colonoscopy discharges from 1019 centers. At the ambulatory surgery center level, the median risk-standardized hospital transfer rate was 0.0% (interquartile range = 0.0%), whereas the hospital-based acute care rate was 2.1% (interquartile range = 0.6%), with few centers (N = 36) having no observed encounters. No correlation was noted between the risk-standardized hospital transfer and hospital-based acute care rates (volume weighted correlation coefficient = 0.04, P = 0.16). Conclusions: Patients more frequently experience hospital-based acute care encounters after colonoscopy than the need for immediate hospital transfer. Broadening existing quality measures to include hospital-based acute care in the postdischarge period may provide a more complete measure of quality.Justin P. Fox, Deepika D'Cunha Burkardt, Isuru Ranasinghe, and Cary P. Gros
Most important outcomes research papers on stroke and transient ischemic attack
No full textThe following are highlights from the new series, Circulation: Cardiovascular Quality and Outcomes Topic Review. This series will summarize the most important manuscripts, as selected by the Editor, that have published in the Circulation portfolio. The objective of this new series is to provide our readership with a timely, comprehensive selection of important papers that are relevant to the quality and outcomes, and general cardiology audience. The studies included in this article represent the most significant research related to stroke and transient ischemic attack. (Circ Cardiovasc Quality and Outcomes. 2014; 7:191-204.) © 2014 American Heart Association, Inc.Rachel Dreyer, Karthik Murugiah, Sudhakar V. Nuti, Kumar Dharmarajan, Serene I. Chen, Ruijun Chen, Brian Wayda, Isuru Ranasinghe, for the Edito
Isolated hypertrophy of the basal ventricular septum: characteristics of patients with and without outflow tract obstruction
No full textAbstract not availableIsuru Ranasinghe, Chadi Ayoub, Chaitu Cheruvu, Saul B. Freedman, John Yiannika
Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment-elevation myocardial infarction in Australia
No full textData source: Data Supplement, http://circoutcomes.ahajournals.org/content/suppl/2012/05/29/CIRCOUTCOMES.112.965111.DC10BACKGROUND: Improving timely access to reperfusion is a major goal of ST-segment-elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. METHODS AND RESULTS: Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services' response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. CONCLUSIONS: Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas.Isuru Ranasinghe, Fiona Turnbull, Andrew Tonkin, Robyn A. Clark, Neil Coffee, David Briege
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