LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 95

Search options

  1. Article ; Online: Impact of frailty on outcomes in acute ST-elevated myocardial infarctions undergoing percutaneous coronary intervention.

    Heaton, Joseph / Singh, Sohrab / Nanavaty, Dhairya / Okoh, Alexis K / Kesanakurthy, Srinivas / Tayal, Rajiv

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

    2023  Volume 101, Issue 4, Page(s) 773–786

    Abstract: Aims: We analyzed the impact of frailty on readmission rates for ST-elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.: Methods and results: The 2016-2019 Nationwide ... ...

    Abstract Aims: We analyzed the impact of frailty on readmission rates for ST-elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.
    Methods and results: The 2016-2019 Nationwide Readmission Database was analyzed for patients admitted with an acute STEMI. Patients were categorized by frailty risk and analyzed for 30-day readmission risk after acute STEMIs, PCI utilization and outcomes, and healthcare resource utilization. Qualifying index admissions were found in 584,918 visits. Low risk frailty was noted in 78.20%, intermediate risk in 20.67%, and high risk in 1.14% of admissions. Thirty-day readmissions occurred in 7.74% of index admissions, increasing with frailty (p < 0.001). Readmission risk increased with frailty, 1.37 times with intermediate and 1.21 times with high-risk frailty. PCI was performed in 86.40% of low-risk, 66.03% of intermediate-risk, and 58.90% of high-risk patients (p < 0.001). Intermediate patients were 55.02% less likely and high-risk patients were 61.26% less likely to undergo PCI (p < 0.001). Length of stay means for index admissions were 2.96, 7.83, and 16.32 days for low, intermediate, and high-risk groups. Intermediate and high-risk frailty had longer length of stay, higher total cost, and were more likely to be discharged to a skilled facility (p < 0.001).
    Conclusion: Among adult, all-payer inpatient visits, frailty discerned by the hospital frailty risk score was associated with increased readmissions, increased healthcare resource utilization, and lower PCI administration.
    MeSH term(s) Adult ; Humans ; ST Elevation Myocardial Infarction/etiology ; Percutaneous Coronary Intervention/adverse effects ; Treatment Outcome ; Hospitalization ; Patient Readmission ; Risk Factors ; Anterior Wall Myocardial Infarction/etiology ; Arrhythmias, Cardiac/etiology
    Language English
    Publishing date 2023-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1459995-8
    ISSN 1522-726X ; 1522-1946
    ISSN (online) 1522-726X
    ISSN 1522-1946
    DOI 10.1002/ccd.30595
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Disparity in hospital admissions and length of stay based on income status for emergency department hypertensive crisis visits.

    Srivastava, Shreya / Vemulapalli, Bhargav / Okoh, Alexis K / Kassotis, John

    Journal of hypertension

    2022  Volume 40, Issue 8, Page(s) 1607–1613

    Abstract: Objective: Racial, gender, and socioeconomic status have been shown to impact the delivery of care. How this impacts the management of hypertensive crisis remains unclear. We aim to identify disparities on admission frequency and length of stay (LOS) ... ...

    Abstract Objective: Racial, gender, and socioeconomic status have been shown to impact the delivery of care. How this impacts the management of hypertensive crisis remains unclear. We aim to identify disparities on admission frequency and length of stay (LOS) among those presenting with hypertensive crisis, as a function of household income.
    Methods: This is a cross-sectional analysis of 2016 emergency department visits and supplemental inpatient data from the Nationwide Emergency Department Sample. Median household income quartiles were established. A multivariable logistic regression model was used to estimate odds of admission in each income quartile. A multivariable linear regression model was used to predict LOS.
    Results: After applying sample weighting, the total number of emergency department visits was 33 727 with 6906, 25 443, and 1378 visits for hypertensive emergency, hypertensive urgency, and unspecified crisis, respectively. There were 13 191, 8889, 6400, 5247 visits in the (first) lowest, second, third , and fourth (highest) income quartiles, respectively. The median age for the study population was 60. The most common comorbidity was chronic kidney disease. Individuals with the highest income, had a lower likelihood of admission, compared with the lowest quartile (adjusted odds ratio: 0.41, 95% CI 0.22-0.74). There was a significant association between income quartile and LOS among hypertensive emergency patients (beta coefficient: 0.407, P value = 0.019).
    Conclusion: In this study, patients with lower income were more likely to be admitted, whereas those with higher income exhibited a longer LOS. Clinicians must be made aware these disparities to ensure equitable delivery of care.
    MeSH term(s) Cross-Sectional Studies ; Emergency Service, Hospital ; Hospitalization ; Hospitals ; Humans ; Length of Stay ; Retrospective Studies
    Language English
    Publishing date 2022-07-05
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000003193
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Bridging the Disparities Gap to Heart Transplantation With Left Ventricular Assist Devices.

    Okoh, Alexis K / Singh, Supreet / Hirji, Sameer

    The Annals of thoracic surgery

    2020  Volume 110, Issue 2, Page(s) 754–756

    MeSH term(s) Continental Population Groups ; Heart Failure ; Heart Transplantation ; Heart-Assist Devices ; Humans
    Language English
    Publishing date 2020-01-30
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2019.12.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Association of Psychosocial Risk Factors With Quality of Life and Readmissions 1-Year After LVAD Implantation.

    Wang, Jeffrey / Okoh, Alexis K / Chen, Yuxuan / Steinberg, Rebecca S / Gangavelli, Apoorva / Patel, Krishan J / Ko, Yi-An / Alexis, Jeffrey D / Patel, Shivani A / Vega, David J / Daneshmand, Mani / DeFilippis, Ersilia M / Breathett, Khadijah / Morris, Alanna A

    Journal of cardiac failure

    2024  

    Abstract: Background: Among patients with advanced heart failure (HF), treatment with a left ventricular assist device (LVAD) improves health-related quality of life (HRQOL). We investigated the association between psychosocial risk factors, HRQOL, and outcomes ... ...

    Abstract Background: Among patients with advanced heart failure (HF), treatment with a left ventricular assist device (LVAD) improves health-related quality of life (HRQOL). We investigated the association between psychosocial risk factors, HRQOL, and outcomes after LVAD implantation.
    Methods: A retrospective cohort (n=9832) of adults aged ≥ 19 years who received durable LVAD between 2008 - 2017 was identified using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Patients were considered to have psychosocial risk factors if ≥1 of the following were present: 1) substance abuse; 2) limited social support; 3) limited cognitive understanding; 4) repeated non-adherence; and 5) major psychiatric disease. Multivariable logistic and linear regression models were used to evaluate the association between psychosocial risk factors and change in Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 scores from baseline to 1-year, persistently poor HRQOL (KCCQ-12 score < 45 at baseline and 1-year), and 1-year rehospitalization.
    Results: Among the final analytic cohort, 2024 (20.6%) patients had ≥1 psychosocial risk factors. Patients with psychosocial risk factors were associated with a smaller improvement in KCCQ-12 scores from baseline to 1-year (Mean ± SD, 29.1 ± 25.9 vs 32.6 ± 26.1, p=0.015) for a difference of -3.51 (95% confidence interval [CI]: -5.88 to -1.13). Psychosocial risk factors were associated with persistently poor HRQOL (adjusted odds ratio [aOR] 1.35, 95% confidence interval [CI] 1.04 - 1.74), and 1-year all-cause readmission (adjusted hazard ratio [aHR] 1.11, 95% CI 1.05 - 1.18). Limited social support, major psychiatric disorder, and repeated non-adherence were associated with persistently poor HRQOL, while major psychiatric disorder was associated with 1-year rehospitalization.
    Conclusion: The presence of psychosocial risk factors is associated with lower KCCQ-12 scores and higher risk for readmission at 1-year after LVAD. While these associations are statistically significant, further research is needed to determine whether these differences are clinically meaningful.
    Language English
    Publishing date 2024-04-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2024.03.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article: Impact of chronic thrombocytopenia on healthcare resource utilization, in-hospital outcomes, and costs following percutaneous coronary intervention of chronic total occlusion: a nationwide propensity weighted analysis.

    Dodoo, Sheriff N / Apenteng, Bettye A / Okoh, Alexis K / Opoku, Isaac A / Egolum, Ugochukwu O / Ghasemzadeh, Nima / Ramadan, Ronnie / Henry, Glen / Giugliano, Gregory

    American journal of cardiovascular disease

    2024  Volume 14, Issue 1, Page(s) 9–20

    Abstract: Background: Data on the impact of chronic thrombocytopenia (CT) on outcomes following chronic total occlusion (CTO) percutaneous coronary interventions (PCI) is limited. Most studies are case reports and focused on postprocedural thrombocytopenia. The ... ...

    Abstract Background: Data on the impact of chronic thrombocytopenia (CT) on outcomes following chronic total occlusion (CTO) percutaneous coronary interventions (PCI) is limited. Most studies are case reports and focused on postprocedural thrombocytopenia. The purpose of this present study is to assess the impact of CT (> one year) on health resource utilization (HRU), in-hospital outcomes, and cost following CTO PCI.
    Methods: We used discharge data from the 2016-2018 National Inpatient Sample and propensity score-weighted approach to examine the association between CT and HRU among patients undergoing CTO PCI. HRU was measured as a binary indicator defined as a length of stay greater than seven days and/or discharge to a non-home setting. The cost was measured as total charges standardized to 2018 dollars. Both outcomes were assessed using generalized linear models adjusted for survey year, and baseline characteristics.
    Results: Relative to its absence, the presence of CT following CTO PCI was associated with a 4.8% increased probability of high HRU (Population Average Treatment Effect (PATE) estimate = 0.048; 95% Confidence Interval (CI) = 0.041-0.055; P<0.001) and approximately $18,000 more in total hospital charges (PATE estimate = +$18,297.98; 95% CI = $15,101.33-$21,494.63, P<0.001).
    Conclusion: Among chronic total occlusion patients undergoing percutaneous coronary intervention, those with chronic thrombocytopenia had higher resource use, including total hospital charges, and worse in-hospital outcomes when compared with those without chronic thrombocytopenia.
    Language English
    Publishing date 2024-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2616844-3
    ISSN 2160-200X
    ISSN 2160-200X
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Disparities in Health and Healthcare: Impact of Race on Resource Utilization and Costs Following Transcatheter Edge-to-Edge Repair.

    Dodoo, Sheriff N / Okoh, Alexis K / Aggarwal, Tanya / Osman, Abdul-Fatawu / Nkansah, Emmanuel / Oseni, Abdullahi / Odiete, Oghenerukevwe / Egolum, Ugochukwu

    Cardiovascular revascularization medicine : including molecular interventions

    2023  Volume 50, Page(s) 13–18

    Abstract: Background: This study sought to investigate health and healthcare disparities in the management of severe mitral regurgitation with transcatheter edge-to-edge repair using MitraClip and how racial differences impact resource utilization and costs.: ... ...

    Abstract Background: This study sought to investigate health and healthcare disparities in the management of severe mitral regurgitation with transcatheter edge-to-edge repair using MitraClip and how racial differences impact resource utilization and costs.
    Methods: We retrospectively analyzed the National Inpatient Sample (NIS) for patients who underwent Transcatheter Edge-to-Edge Repair (TEER) using MitraClip between 2016 and 2018. The patients were stratified into four racial cohorts and study outcomes included high resource utilization (HRU), periprocedural complications, and total procedural costs. High resource utilization (HRU) was defined as length of stay (LOS) ≥7 days or a nonhome disposition at discharge. Multivariate logistic regression models were utilized to determine independent predictors of HRU.
    Results: 17,100 weighted TEER patients were segregated by race: Caucasian (n = 13,270), others (n = 1510), African Americans, AA (n = 1245) and Hispanics (n = 1075). More African Americans and Hispanics had TEER at Urban facilities (P < 0.001), which were teaching hospitals as well (P < 0.001) but were less likely to be covered by public insurance options -Medicare or Medicaid (P < 0.001). More AA (52.2 %) and Hispanics (27.6 %) were likely to be in the lowest median annual income quartile versus Caucasians (19.2 %) (P = 0.003). AA and Hispanics had higher resource utilization (HRU), prolonged length of stay, nonhome disposition at discharge, higher procedural costs and periprocedural complications versus Caucasians. The logistic regression model revealed acute kidney injury (AKI) and actual procedural costs as independent predictors of HRU in both African American and Hispanic groups.
    Conclusion: Significant Health and healthcare disparities do exist among underrepresented, racial minority patients undergoing transcatheter edge-to-edge repair in the US. These disparities were associated with higher resource utilization and actual costs in patients with mitral regurgitation treated with TEER.
    MeSH term(s) Humans ; Aged ; United States ; Mitral Valve Insufficiency/surgery ; Retrospective Studies ; Medicare ; Healthcare Disparities ; Treatment Outcome ; Heart Valve Prosthesis Implantation ; White
    Language English
    Publishing date 2023-01-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2023.01.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: COVID-19 Pneumonia in Patients With HIV: A Case Series.

    Okoh, Alexis K / Bishburg, Eliahu / Grinberg, Sagy / Nagarakanti, Sandhya

    Journal of acquired immune deficiency syndromes (1999)

    2020  Volume 85, Issue 1, Page(s) e4–e5

    MeSH term(s) Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/pathology ; Female ; HIV Infections/complications ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/pathology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000002411
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Racial disparities in long-term survival after heart transplantation: What should we be telling patients?

    Okoh, Alexis K / Wang, Jeffrey / Gangavelli, Apoorva / Steinberg, Rebecca / Nayak, Aditi / Gupta, Divya / Daneshmand, Mani / Morris, Alanna A

    Clinical transplantation

    2022  Volume 36, Issue 9, Page(s) e14760

    MeSH term(s) Health Status Disparities ; Healthcare Disparities ; Heart Transplantation ; Humans ; Racial Groups ; United States
    Language English
    Publishing date 2022-07-08
    Publishing country Denmark
    Document type Letter ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.14760
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: The Impact of Frailty on Outcomes of Proximal Aortic Aneurysm Surgery: A Nationwide Analysis.

    Percy, Edward D / Faggion Vinholo, Thais / Newell, Paige / Singh, Supreet / Hirji, Sameer / Awtry, Jake / Semco, Robert / Chowdhury, Muntasir / Reed, Alexander K / Asokan, Sainath / Malarczyk, Alexandra / Okoh, Alexis / Harloff, Morgan / Yazdchi, Farhang / Kaneko, Tsuyoshi / Sabe, Ashraf A

    Journal of cardiovascular development and disease

    2024  Volume 11, Issue 1

    Abstract: 1) Background: This study examines frailty's impact on proximal aortic surgery outcomes. (2) Methods: All patients with a thoracic aortic aneurysm who underwent aortic root, ascending aorta, or arch surgery from the 2016-2017 National Inpatient Sample ... ...

    Abstract (1) Background: This study examines frailty's impact on proximal aortic surgery outcomes. (2) Methods: All patients with a thoracic aortic aneurysm who underwent aortic root, ascending aorta, or arch surgery from the 2016-2017 National Inpatient Sample were included. Frailty was defined by the Adjusted Clinical Groups Frailty Indicator. Outcomes of interest included in-hospital mortality and a composite of death, stroke, acute kidney injury (AKI), and major bleeding (MACE). (3) Results: Among 5745 patients, 405 (7.0%) met frailty criteria. Frail patients were older, with higher rates of chronic pulmonary disease, diabetes, and chronic kidney disease. There was no difference in in-hospital death (4.9% vs. 2.4%,
    Language English
    Publishing date 2024-01-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2777082-5
    ISSN 2308-3425 ; 2308-3425
    ISSN (online) 2308-3425
    ISSN 2308-3425
    DOI 10.3390/jcdd11010032
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: The top 100 Twitter influencers in cardiology.

    Kesiena, Onoriode / Onyeaka, Henry K / Fugar, Setri / Okoh, Alexis K / Volgman, Annabelle Santos

    AIMS public health

    2021  Volume 8, Issue 4, Page(s) 743–753

    Abstract: Importance: Twitter represents a growing aspect of the social media experience and is a widely used tool for public education in the 21: Objective: We sought to identify the top 100 Twitter influencers within cardiology, characterize them, and ... ...

    Abstract Importance: Twitter represents a growing aspect of the social media experience and is a widely used tool for public education in the 21
    Objective: We sought to identify the top 100 Twitter influencers within cardiology, characterize them, and examine the relationship between their social media activity and academic influence.
    Design: Twitter topic scores for the topic search "cardiology" were queried on May 01, 2020 using the Right Relevance application programming interface (API). Based on their scores, the top 100 influencers were identified. Among the cardiologists, their academic h-indices were acquired from Scopus and these scores were compared to the Twitter topic scores.
    Result: We found out that 88/100 (88%) of the top 100 social media influencers on Twitter were cardiologists. Of these, 63/88 (72%) were males and they practiced mostly in the United States with 50/87 (57%) practicing primarily in an academic hospital. There was a moderately positive correlation between the
    Conclusion: Our study highlights that the top ranked cardiology social media influencers on Twitter are board-certified male cardiologists practicing in academic settings in the US. The most influential on Twitter have a moderate influence in academia. Further research should evaluate the relationship between other academic indices and social media influence.
    Language English
    Publishing date 2021-10-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2777115-5
    ISSN 2327-8994 ; 2327-8994
    ISSN (online) 2327-8994
    ISSN 2327-8994
    DOI 10.3934/publichealth.2021058
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top