The study sought to determine whether rapid access to medical care and reperfusion results in a better prognosis in patients with in-hospital compared with out-of-hospital stent thrombosis (ST) in patients with ST-segment elevation myocardial infarction (STEMI) in the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial. ...

OBJECTIVE: The use of cell phones and short message service (SMS, also called "texting") has become pervasive in Western society and increasingly throughout the world. Despite the importance of this technology in everyday life, little is known about how patients draw on SMS to keep in contact with family and ...

To analyze nationwide trends in abdominal aortic aneurysm (AAA) repair and the use of endovascular abdominal aortic aneurysm repair (EVAR) in the emergency setting. Data were obtained from the Nationwide Inpatient Sample (NIS) using the International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes for open and endovascular repairs from ...

OBJECTIVES: Hospital procedure volume has been strongly associated with postoperative mortality for a number of complex cardiovascular procedures. Although not yet described, a similar relationship might be expected for surgical procedures involving the aortic root and/or ascending aorta. The present study sought to evaluate the relationship between the volume of ...

The aim of this investigation was to examine the impact of hospital annual mitral volume on mitral valve (MV) repair rates and mortality. The 2005-2008 Nationwide Inpatient Sample (NIS) database was searched to identify patients who had undergone either MV repair (ICD-9-CM code 35.12) or MV replacement (ICD-9-CM codes 35.23 ...

There is paucity of data relating to the geographic variation in mitral valve (MV) repair trends and outcomes of patients undergoing MV surgery. Using the 2005-2008 Nationwide Inpatient Sample (NIS) Database, the four geographic regions of the US (Northeast, Midwest, South, and West) were compared with respect to baseline characteristics, ...

To decrease the load of pharmaceuticals to the environment, decentralized wastewater treatment has been proposed for important point-sources such as hospitals. In this study, a microbial electrolysis cell (MEC) was used for the dehalogenation of the iodinated X-ray contrast medium diatrizoate. The presence of biogenic palladium nanoparticles (bio-Pd) in the ...

The identity of the Roman Catholic priesthood remains in serious crisis. Scholars have called for a return to traditional sources to find possible solutions, including the Early Church Fathers and the Hebrew Bible. Following Oden, this article further explores Pope Gregory the Great's The Book of Pastoral Rule and his ...

An 18-year-old man was transferred to the authors' institution after a motor vehicle collision in which he was a restrained front seat passenger. The referring hospital performed contrast-enhanced computed tomography which revealed a previously undiagnosed horseshoe kidney with a laceration of the right lower pole moiety. On transfer, he was ...

The purpose of this study was to evaluate the prognostic importance of novel markers of renal dysfunction among patients with acutely destabilized heart failure (ADHF). β-trace protein (BTP) and cystatin C are newer biomarkers for renal dysfunction; the prognostic importance of these tests, particularly BTP, relative to standard measures of ...

There is very little information about the relationship between hyperuricemia, acute kidney injury (AKI) and in-hospital mortality. With a retrospective analysis of the medical records, 1,247 patients who had percutaneous coronary intervention (PCI) were investigated. AKI was defined as an increase in serum creatinine of ≥0.5mg/dl or ≥50% over baseline ...

No population-based studies have described the prevalence of acute kidney injury (AKI) treated with renal replacement therapy (RRT) in Japan. This study prospectively examined the incidence of AKI requiring RRT by surveying 16 hospitals in Shizuoka prefecture from January to October 2006. The subjects comprised 242 patients treated with RRT ...

Hospitalizations for acute heart failure syndromes (AHFS) are associated with high post-discharge mortality and readmission rates in spite of available therapies. Renin-angiotensin-aldosterone system (RAAS) antagonists improve outcomes in outpatients with heart failure (HF) and reduced ejection fraction, however these therapies have not been tested in AHFS. Aliskiren is a direct ...

Clinical registries are used increasingly to analyze quality and outcomes, but the generalizability of findings from registries is unclear. We linked data from the Acute Decompensated Heart Failure National Registry (ADHERE) to 100% fee-for-service Medicare claims data. We compared patient characteristics and inpatient mortality of linked and unlinked ADHERE hospitalizations; ...

To evaluate the quality of life in heart failure (HF) outpatients attending multidisciplinary disease management programmes at HF clinics in Norwegian hospitals. Data from HF patients at 24 hospital outpatient clinics were entered in a common database; The Norwegian Heart Failure Registry. Quality of life assessment was done using Minnesota ...

Monitoring of intrathoracic impedance to evaluate heart failure status has been used for some years in the outpatient setting. Recent technological advances in pacemaker and internal cardioverter-defibrillator design allow for easier access to that same information in the inpatient setting. This has implications for earlier and more precise recognition and ...

BACKGROUND: Initiatives to develop Adult Congenital Centers for management of grown-up congenital heart disease (GUCH) patients (aged >/=18 years) have widened without evidence identifying the ideal clinical environment. To elucidate the optimum care paradigm, we investigated whether mortality for patients with GUCH was influenced by the type of hospital where ...

OBJECTIVES: This study sought to determine recent trends over time in heart failure hospitalization, patient characteristics, treatment, rehospitalization, and mortality within the Veterans Affairs health care system. BACKGROUND: Use of recommended therapies for heart failure has increased in the U.S. However, it is unclear to what extent hospitalization rates and ...

Kidney disease is common among patients with heart failure, but relationships between worsening renal function (WRF) and outcomes after hospitalization for heart failure are poorly understood, especially among patients with preserved systolic function. We examined associations between WRF and 30-day readmission, mortality, and costs among Medicare beneficiaries hospitalized with heart ...

To determine the rate and nature of complaints and the outcomes of the complaint management at a large heart centre in Tehran. A retrospective review of all verbal and written complaints recorded over 30 months. A large heart centre in Tehran, Iran. Population All 312,105 admissions (47,041 inpatients, 138,842 outpatients ...

The objectives of this study were to examine the type and frequency of symptoms in patients hospitalized with acute heart failure (HF) as well as the relationship between symptom patterns and patient characteristics, treatment practices, and hospital outcomes in patients hospitalized with decompensated HF. The study sample consisted of 4537 ...

OBJECTIVE: To characterize the clinical presentation, management, and in-hospital outcomes of dogs and cats diagnosed with acute congestive heart failure (CHF). DESIGN: Retrospective study of animals seen between January 2007 and May 2008. SETTING: Emergency service at a university teaching hospital. ANIMALS: Ninety dogs and 55 cats with CHF. MEASUREMENTS ...

Heart failure case management programs have been shown in clinical trials to be highly effective at preventing future hospitalizations. But the absolute benefits of these programs depend on the baseline risk of outcome in the treated population. Because baseline risks of hospitalization in trials are often higher than community-based samples, ...

OBJECTIVE: It is often claimed that hospitals that are leaders in biomedical research provide higher health care quality, or vice versa. Although several studies have shown a relationship between teaching status and quality of care, none has analysed the association between research output and hospital outcomes. Our aim was to ...

CONTEXT: Readmission after hospitalization for heart failure is common. Early outpatient follow-up after hospitalization has been proposed as a means of reducing readmission rates. However, there are limited data describing patterns of follow-up after heart failure hospitalization and its association with readmission rates. OBJECTIVE: To examine associations between outpatient follow-up ...

This study is a retrospective analysis of medical claims of individuals with diabetes enrolled in managed Medicaid as well as a diabetes management program. The sample consists of 695 individuals who had at least two hospitalizations in one calendar year. This study had two related aims. The first was to ...

OBJECTIVE: To compare the predictive accuracy of regression trees with that of logistic regression models for predicting in-hospital mortality in patients hospitalized with heart failure. STUDY DESIGN AND SETTING: Models were developed in 8,236 patients hospitalized with heart failure between April 1999 and March 2001. Models included the Enhanced Feedback ...

Proton-pump inhibitors (PPIs) and clopidogrel are frequently coprescribed, although the benefits and harms of their concurrent use are unclear. To examine the association between concurrent use of PPIs and clopidogrel and the risks for hospitalizations for gastroduodenal bleeding and serious cardiovascular disease. Retrospective cohort study using automated data to identify ...

Hospitalization for heart failure (HF) marks a substantial crossroad for patients, as greater than one-third will be re-hospitalized or dead within 90 days post-discharge. For patients with chronic HF who present with acute heart failure syndromes (AHFS), they transition from an arena of well-established and life-saving evidence-based therapies to one ...

In older heart failure (HF) patients, survival depends on the severity of their cardiac condition and on their functional status. Lower extremity performance, assessed with the Short Physical Performance Battery (SPPB), predicts survival in older persons, both in epidemiologic and clinical settings. We evaluated whether SPPB predicts long-term survival in ...

The prognostic value of left and right bundle branch blocks (LBBB and RBBB) in hospitalized heart failure (HF) patients is unclear. We sought to determine the prognostic value of bundle branch blocks in patients hospitalized with heart failure. The associations of BBB type with death, HF hospitalizations or cardiovascular hospitalizations ...

Background: Heart failure case management programs have been shown to be highly effective at preventing future hospitalizations in clinical trials. But these programs absolute benefits depend on the baseline risk of outcome in the treated population. Since baseline risks of hospitalization in trials are often higher than community-based samples, translating ...

BACKGROUND: Congestive heart failure (CHF) is an increasingly common condition associated with significant hospital resource utilization. Initiating better disease management at the time of initial hospital admission has the potential to reduce readmissions. OBJECTIVE: To evaluate the impact of a multifaceted quality improvement program on 12-month hospital utilization in patients ...

This review examined the effectiveness of self-management interventions compared to usual care on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure. A systematic review was performed. MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched between 1996 and 2009. ...

Hospitalized heart failure (HF) patients are at high risk for death and readmission. We examined the incremental value of data obtained 1 week after HF hospital discharge in predicting mortality and readmission. In the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with tolvaptan, 1528 hospitalized patients (ejection fraction ...

Recent efforts to improve care for patients hospitalized with heart failure have focused on process-based performance measures. Data supporting the link between current process measures and patient outcomes are sparse. To examine the relationship between adherence to hospital-level process measures and long-term patient-level mortality and readmission. Analysis of data from ...

BACKGROUND: We performed a prospective, randomized investigation assessing the incremental effect of automated health monitoring (AHM) technology over and above that of a previously described nurse directed heart failure (HF) disease management program. The AHM system measured and transmitted body weight, blood pressure, and heart rate data as well as ...

Systematic analysis of error recovery can provide hospitals with important information to help them improve their ability to detect and correct errors. Because errors will always crop up and 100% safety can never be achieved, hospitals should be able to prevent patient harm by timely and effective error recovery. In ...

We investigated whether prior hospitalization was a risk factor for heart attacks among older adults in the survey on Assets and Health Dynamics among the Oldest Old. Baseline (1993-1994) interview data were linked to 1993-2005 Medicare claims for 5,511 self-respondents aged 70 years and older and not enrolled in managed ...

Although noninvasive ventilation (NIV) is becoming very popular, little is known about its pattern of clinical and technical utilisation in different environments. We conducted a web-based survey in Europe to identify the perceived pattern of NIV utilisation and the reason for choosing a specific ventilator and interface type in four ...

This study aimed to update the long-term trend of coronary heart disease (CHD), cerebrovascular disease (CBVD), and heart failure (HF) hospitalization rates and HF comorbidity among adults aged 65 and older in the United States. Data from the National Hospital Discharge Surveys between 1980 and 2006 were used. CHD, CBVD, ...

Chest X-ray interpretation is an important skill in the diagnosis of congestive heart failure (CHF) by emergency physicians. This study evaluated the ability of emergency physicians to recognize CHF on chest X-ray and the effect of level of training and confidence upon accuracy of interpretation. This was a prospective, blinded ...

Acute heart failure syndrome (AHFS) is a major public health problem. It is defined as gradual or rapid change in heart failure (HF) signs and symptoms, which often results in an unplanned hospitalization and a need for urgent therapy. Many evidence-based pharmacologic, device, and surgical treatment for HF are available ...

Remote monitoring (RM) of homebound heart failure (HF) patients has previously been shown to reduce hospital admissions. We conducted a pilot trial of ambulatory, non-homebound patients recently hospitalized for HF to determine whether RM could be successfully implemented in the ambulatory setting. Eligible patients from Massachusetts General Hospital (n = ...

BACKGROUND: Physical activity (PA) has proven benefits in the primary prevention of heart diseases such as heart failure (HF). Although it is well known, HF PA habits and physicians' advice have been poorly described. The aim of this study was to investigate if physicians were advising HF patients to exercise ...

BACKGROUND: Effective risk stratification can inform clinical decision-making. Our objective was to derive and validate a risk score for in-hospital mortality in patients hospitalized with heart failure using American Heart Association Get With the Guidelines-Heart Failure (GWTG-HF) program data. METHODS AND RESULTS: A cohort of 39 783 patients admitted January ...

This report presents a field-tested approach to the greatest health care problem facing our country, the fact that two-thirds of the deaths from acute myocardial infarction occur before hospital admission. Scores of fundraising appearances for the Missouri Heart Association during the 1950s and 1960s throughout the 1,000,000 population rural/urban Southwest ...

Wang Qingren, a Chinese physician, made interesting observations regarding the cardiovascular system approximately 200 years ago. His textbook of anatomy was based on cadaveric dissections only and this resulted in many of his observations being erroneous. Nevertheless, Wang made steps forward in reversing past misconceptions based on Chinese mysticism.

In July 2009, Medicare began publicly reporting hospitals' risk-standardized 30-day all-cause readmission rates (RSRRs) among fee-for-service beneficiaries discharged after hospitalization for heart failure from all the US acute care nonfederal hospitals. No recent national trends in RSRRs have been reported, and it is not known whether hospital-specific performance is improving ...

We describe the prevalence and prognostic significance of heart failure (HF) complicating acute coronary syndromes (ACS) in patients enrolled in the Gulf Registry of Acute Coronary Events (Gulf RACE). Gulf RACE is a prospective, multi-national study of all patients hospitalized with ACS in 65 centres in six Arab countries. Data ...