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Trends of psychiatric co-morbidities amongst patients with hypertrophic cardiomyopathy: A large observational cohort study spanning 14 years. Res Cardiovasc Med 2017. [DOI: 10.5812/cardiovascmed.32732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Impact of cardiovascular risk factors and disease on length of stay and mortality in patients with acute coronary syndromes. Int J Cardiol 2016; 220:745-9. [DOI: 10.1016/j.ijcard.2016.06.188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/24/2016] [Indexed: 12/17/2022]
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Hayes RM, Carter PR, Gollop ND, Uppal H, Sarma J, Chandran S, Potluri R. The impact of marital status on mortality and length of stay in patients admitted with acute coronary syndrome. Int J Cardiol 2016; 212:142-4. [DOI: 10.1016/j.ijcard.2016.03.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/16/2016] [Indexed: 11/26/2022]
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Ziaei F, Zaman M, Rasoul D, Gorantla RS, Bhayani R, Shakir S, Shan SKA, Khan J, Uppal H, Chandran S, Potluri R. The prevalence of atrial fibrillation amongst heart failure patients increases with age. Int J Cardiol 2016; 214:410-1. [PMID: 27088400 DOI: 10.1016/j.ijcard.2016.03.198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/29/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Fatemeh Ziaei
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Mahvash Zaman
- Department of Cardiology, University Hospital of South Manchester NHS Trust, Manchester, UK
| | - Debar Rasoul
- Department of Cardiology, Royal Liverpool and Broadgreen NHS Trust, Liverpool, UK
| | - Ramakrishna S Gorantla
- Department of Internal Medicine, Bassett Medical Center, Columbia University of Physicians and Surgeons, Cooperstown, USA
| | - Raj Bhayani
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Savana Shakir
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Syed K A Shan
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Joshim Khan
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Hardeep Uppal
- ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK
| | - Suresh Chandran
- Department of Medicine, Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Rahul Potluri
- ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK.
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Carter P, Reynolds J, Carter A, Potluri S, Uppal H, Chandran S, Potluri R. The impact of psychiatric comorbidities on the length of hospital stay in patients with heart failure. Int J Cardiol 2016; 207:292-6. [DOI: 10.1016/j.ijcard.2016.01.132] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/11/2015] [Accepted: 01/05/2016] [Indexed: 11/25/2022]
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Potluri R, Reynolds J, Carter P, Baig M, Aziz A, Potluri S, Ali N, Uppal H, Chandran S. The role of angioplasty in octogenarian patients with Acute Coronary Syndrome. Int J Cardiol 2016; 202:430-2. [DOI: 10.1016/j.ijcard.2015.09.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/21/2015] [Indexed: 12/16/2022]
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Uppal H, Chandran S, Potluri R. Risk factors for mortality in Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:873-881. [PMID: 25851193 DOI: 10.1111/jir.12196] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Down syndrome is a genetic condition that contributes to a significantly shorter life expectancy compared with the general population. We investigated the most common comorbidities in a population of acute hospital patients with Down syndrome and further explored what the most common risk factors for mortality are within this population. METHOD From our database of one million patients admitted to National Health Service (NHS) Trusts in northern England, we identified 558 people who had Down syndrome. We compared this group with an age- and gender-matched control group of 5580 people. RESULTS The most prevalent comorbid diseases within the Down's population were hypothyroidism (22.9%) and epilepsy (20.3%). However, the conditions that had the highest relative risks (RRs) in the Down's population were septal defects and dementia. Respiratory failure, dementia and pneumonia were the most significantly related comorbidities to mortality in the Down syndrome population. In the control population, respiratory failure, dementia and renal failure were the most significant disease contributors. When these contributors were analysed using multivariate analysis, heart failure, respiratory failure, pneumonia and epilepsy were the identified risk factors for in-hospital mortality in the Down syndrome population. Respiratory failure was the sole risk factor for mortality in the Down syndrome population [RR = 9.791 (1.6-59.9) P ≤ 0.05], when compared with the risk factors for mortality in the control population. CONCLUSIONS There is significant medical morbidity in Down syndrome. This morbidity contributes to the lower life expectancy. Respiratory failure is a risk factor for mortality in Down syndrome. We need to thoroughly investigate people with Down syndrome to ensure any treatable illnesses are well managed.
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Affiliation(s)
- H Uppal
- ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK
| | - S Chandran
- Department of Acute Medicine, North Western Deanery, Oldham, UK
| | - R Potluri
- ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK
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Shan SKA, McConnell O, Khan J, Ziaei F, Bhayani R, Shakir S, Potluri S, Gorantla RS, Uppal H, Chandran S, Potluri R. The impact of ethnicity on the prevalence and length of hospital stay in patients with mitral regurgitation. Int J Cardiol 2015; 195:15-6. [DOI: 10.1016/j.ijcard.2015.05.097] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/17/2015] [Indexed: 11/27/2022]
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Rasoul D, Potluri S, Wong SC, Gorantla RS, Aziz A, Chandran S, Uppal H, Potluri R. Psychiatric co-morbidities in patients with dilated cardiomyopathy. Int J Cardiol 2015; 191:71-3. [DOI: 10.1016/j.ijcard.2015.04.271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
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Gorantla RS, Nimmagadda M, Potluri S, Uppal H, Chandran S, Potluri R. Ethnic variations in length of hospital stay in patients with atrial fibrillation. Int J Cardiol 2015; 187:542-4. [DOI: 10.1016/j.ijcard.2015.03.405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 03/28/2015] [Indexed: 01/01/2023]
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Yssennagger L, Gollop ND, Gorantla RS, Nimmagadda M, Potluri S, Uppal H, Chandran S, Potluri R. Increasing burden of psychiatric comorbidities amongst patients with Ischaemic Heart Disease. Int J Cardiol 2015; 186:200-1. [DOI: 10.1016/j.ijcard.2015.03.193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 03/17/2015] [Indexed: 12/01/2022]
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Potluri R, Wasim M, Markandey B, Kapour A, Khouw N, Carter P, Uppal H, Chandran S. Length of hospital stay is shorter in South Asian patients with ischaemic stroke. Int J Cardiol 2015; 187:190-1. [DOI: 10.1016/j.ijcard.2015.03.290] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/07/2015] [Indexed: 10/23/2022]
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Li Q, Lin Z, Masoudi FA, Li J, Li X, Hernández-Díaz S, Nuti SV, Li L, Wang Q, Spertus JA, Hu FB, Krumholz HM, Jiang L. National trends in hospital length of stay for acute myocardial infarction in China. BMC Cardiovasc Disord 2015; 15:9. [PMID: 25603877 PMCID: PMC4360951 DOI: 10.1186/1471-2261-15-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 01/12/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND China is experiencing increasing burden of acute myocardial infarction (AMI) in the face of limited medical resources. Hospital length of stay (LOS) is an important indicator of resource utilization. METHODS We used data from the Retrospective AMI Study within the China Patient-centered Evaluative Assessment of Cardiac Events, a nationally representative sample of patients hospitalized for AMI during 2001, 2006, and 2011. Hospital-level variation in risk-standardized LOS (RS-LOS) for AMI, accounting for differences in case mix and year, was examined with two-level generalized linear mixed models. A generalized estimating equation model was used to evaluate hospital characteristics associated with LOS. Absolute differences in RS-LOS and 95% confidence intervals were reported. RESULTS The weighted median and mean LOS were 13 and 14.6 days, respectively, in 2001 (n = 1,901), 11 and 12.6 days in 2006 (n = 3,553), and 11 and 11.9 days in 2011 (n = 7,252). There was substantial hospital level variation in RS-LOS across the 160 hospitals, ranging from 9.2 to 18.1 days. Hospitals in the Central regions had on average 1.6 days (p = 0.02) shorter RS-LOS than those in the Eastern regions. All other hospital characteristics relating to capacity for AMI treatment were not associated with LOS. CONCLUSIONS Despite a marked decline over the past decade, the mean LOS for AMI in China in 2011 remained long compared with international standards. Inter-hospital variation is substantial even after adjusting for case mix. Further improvement of AMI care in Chinese hospitals is critical to further shorten LOS and reduce unnecessary hospital variation.
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Affiliation(s)
- Qian Li
- />Department of Epidemiology, Harvard School of Public Health, Boston, MA USA
- />Epidemiology, Worldwide Safety & Regulatory, Pfizer Inc., New York, NY USA
| | - Zhenqiu Lin
- />Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT USA
| | - Frederick A Masoudi
- />Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Jing Li
- />National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037 China
| | - Xi Li
- />National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037 China
| | | | - Sudhakar V Nuti
- />Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT USA
| | - Lingling Li
- />Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Qing Wang
- />National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037 China
| | - John A Spertus
- />Saint Luke’s Mid America Heart Institute, Kansas City, MO USA
| | - Frank B Hu
- />Department of Epidemiology, Harvard School of Public Health, Boston, MA USA
- />Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- />Department of Nutrition, Harvard School of Public Health, Boston, MA USA
| | - Harlan M Krumholz
- />Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT USA
| | - Lixin Jiang
- />National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037 China
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Prevalence and length of hospital stay in patients with aortic valve disease is lower amongst South Asians. Int J Cardiol 2014; 177:34-6. [DOI: 10.1016/j.ijcard.2014.09.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/16/2014] [Indexed: 11/24/2022]
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Prolonged length of hospital stay in Far-East Asian and Afro-Caribbean patients with cardiomyopathy. Int J Cardiol 2014; 176:230-1. [DOI: 10.1016/j.ijcard.2014.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 05/29/2014] [Accepted: 06/20/2014] [Indexed: 11/23/2022]
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The role of angioplasty in patients with acute coronary syndrome and previous coronary artery bypass grafting. Int J Cardiol 2014; 176:760-3. [PMID: 25135330 DOI: 10.1016/j.ijcard.2014.07.097] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 07/26/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Angioplasty has changed the management of acute coronary syndrome (ACS). However, in patients with previous coronary artery bypass grafting (CABG), the role of angioplasty in the management of ACS is widely debated. Lack of clear guidelines leads to subjective and often stereotypical assessments based on clinician preferences. We sought to investigate if angioplasty affected all cause mortality in ACS patients with previous CABG. METHODS Completely anonymous information on patients with ACS with a background of previous CABG, co-morbidities and procedures attending three multi-ethnic general hospitals in the North West of England, United Kingdom in the period 2000-2012 was traced using the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) study protocol using ICD-10 and OPCS-4 coding systems. Predictors of mortality and survival analyses were performed using SPSS version 20.0. RESULTS Out of 12,227 patients with ACS, there were 1172 (19.0%) cases of ACS in patients with previous coronary artery bypass grafting. Of these 83 (7.1%) patients underwent angioplasty. Multi-nominal logistic regression, accounting for differences in age and co-morbidities, revealed that having angioplasty conferred a 7.96 times improvement in mortality (2.36-26.83 95% CI) compared to not having angioplasty in this patient group. CONCLUSIONS We have shown that angioplasty confers significantly improved all cause mortality in the management of ACS in patients with previous CABG. The findings of this study highlight the need for clinicians to conscientiously think about the individual benefits and risks of angioplasty for every patient rather than confining to age related stereotypes.
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Teo R, Gollop ND, Baig M, Uppal H, Chandran S, Potluri R. The burden and trends of psychiatric co-morbidities amongst patients with cardiomyopathy. Int J Cardiol 2014; 174:398-9. [DOI: 10.1016/j.ijcard.2014.04.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
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Ciputra RN, Sembiring YE, Prawoto OL, Khouw N, Baig M, Uppal H, Chandran S, Potluri R. Length of stay in hospital is longer in ethnic minority patients after coronary artery bypass surgery. Int J Cardiol 2014; 172:e434-5. [DOI: 10.1016/j.ijcard.2013.12.182] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
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Trends of cardiovascular disease amongst psychiatric patients between 2001 and 2012 in Greater Manchester, UK. Int J Cardiol 2014; 173:573-4. [PMID: 24698254 DOI: 10.1016/j.ijcard.2014.03.116] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 03/14/2014] [Indexed: 11/20/2022]
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