Getting better or getting by?: A qualitative study of in-hospital cardiac arrest survivors long-term recovery experiences.

In the United States, approximately 292,000 adults (>18 years old) per year suffer an in-hospital cardiac arrest (IHCA). Survival rates have increased over the last decade and many survivors return to their communities. IHCA has been recognized as a unique disease entity because the arrest happens in a medical care setting and survivors often have more medical co-morbidities.

Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans.

Klawitter, L, Vincent, BM, Choi, BJ, Smith, J, Hammer, KD, Jurivich, DA, Dahl, LJ, and McGrath, R. Handgrip strength asymmetry and weakness are associated with future morbidity accumulation in americans. J Strength Cond Res 36(1): 106-112, 2022-Identifying strength asymmetries in physically deconditioned populations may help in screening and treating persons at risk for morbidities linked to muscle dysfunction.

Hospital-specific Template Matching for Benchmarking Performance in a Diverse Multihospital System.

Background: Hospital-specific template matching is a newer method of hospital performance measurement that may be fairer than regression-based benchmarking. However, it has been tested in only limited research settings.

Objective: The objective of this study was to test the feasibility of hospital-specific template matching assessments in the Veterans Affairs (VA) health care system and determine power to detect greater-than-expected 30-day mortality.

Self-Reported Dementia-Related Diagnosis Underestimates the Prevalence of Older Americans Living with Possible Dementia.

Background: Dementia screening is an important step for appropriate dementia-related referrals to diagnosis and treat possible dementia.

Objective: We sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally representative sample of older Americans with a cognitive impairment consistent with dementia (CICD).

Methods: The weighted analytical sample included 6,036,224 Americans aged at least 65 years old that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 Health and Retirement Study.

The Associations of Handgrip Strength and Leg Extension Power Asymmetry on Incident Recurrent Falls and Fractures in Older Men.

Background: Evaluating asymmetries in muscle function could provide important insights for fall risk assessments. We sought to determine the associations of (i) handgrip strength (HGS) asymmetry and (ii) leg extension power (LEP) asymmetry on risk of incident recurrent falls and fractures in older men.

Method: There were 5 730 men with HGS asymmetry data and 5 347 men with LEP asymmetry data from the Osteoporotic Fractures in Men (MrOS) study.

Handgrip Weakness and Asymmetry Independently Predict the Development of New Activity Limitations: Results from Analyses of Longitudinal Data from the US Health and Retirement Study.

Objectives: Examining strength asymmetries in assessments of muscle function may improve screenings for limitations in independent living tasks such as instrumental activities of daily living (IADL). We sought to determine the associations between handgrip strength (HGS) asymmetry and future IADL limitations in aging Americans.

Design: Longitudinal panel.

Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment.

Objective: The seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG antibody was evaluated among employees of a Veterans Affairs healthcare system to assess potential risk factors for transmission and infection.

Methods: All employees were invited to participate in a questionnaire and serological survey to detect antibodies to SARS-CoV-2 as part of a facility-wide quality improvement and infection prevention initiative regardless of clinical or nonclinical duties. The initiative was conducted from June 8 to July 8, 2020.

Handgrip Strength Asymmetry and Weakness May Accelerate Time to Mortality in Aging Americans.

Objectives: Assessing handgrip strength (HGS) asymmetry may provide insights into HGS as a prognostic assessment of strength capacity and vitality. This study sought to determine the associations of HGS asymmetry and weakness on time to mortality in aging Americans.

Design: Longitudinal panel.

Developing a template matching algorithm for benchmarking hospital performance in a diverse, integrated healthcare system.

Template matching is a proposed approach for hospital benchmarking, which measures performance based on matching a subset of comparable patient hospitalizations from each hospital. We assessed the ability to create the required matched samples and thus the feasibility of template matching to benchmark hospital performance in a diverse healthcare system.Nationwide Veterans Affairs (VA) hospitals, 2017.

Statin discontinuation and new antipsychotic use after an acute hospital stay vary by hospital.

Introduction: Patients are at risk for medication problems after hospital admissions, particularly those with critical illness. Medication problems include continuation of acute medications and discontinuation of chronic medications after discharge. Little is known across a national integrated health care system about the extent of these two medication problems.

Handgrip Strength Asymmetry and Weakness Together Are Associated With Functional Disability in Aging Americans.

Background: Evaluating handgrip strength (HGS) asymmetry may help to improve the prognostic value of HGS. This study sought to determine the associations of HGS asymmetry and weakness on future activities of daily living (ADL) disability in a national sample of aging Americans.

Methods: The analytic sample included 18,468 Americans aged ≥50 years from the 2006-2016 waves of the Health and Retirement Study.

Sleeping time is associated with functional limitations in a national sample of older Americans.

Background: Engaging in healthy behaviors may help to preserve function during aging; however, it is not well understood how sleeping time is associated with functional capacity in older adults.

Aims: We sought to determine the association of sleeping time on functional limitation in a national sample of older Americans.

Methods: The analytical sample included 6020 adults aged at least 65 years who participated in the 2007-2016 waves of the National Health and Nutrition Examination Survey.

Absolute and Body Mass Index Normalized Handgrip Strength Percentiles by Gender, Ethnicity, and Hand Dominance in Americans.

Background: Gender and ethnicity are factors which influence strength, and hand dominance could be a critical component of handgrip strength (HGS) testing. Providing such HGS percentiles across the lifespan may help to identify weakness-related health concerns. We sought to generate growth charts and curves for HGS by gender and ethnicity in a nationally-representative sample of Americans aged 6-80 years.

Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis.

Objectives: Quantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities.

Design: Longitudinal panel.

The burden of health conditions across race and ethnicity for aging Americans: Disability-adjusted life years.

Despite evidence suggesting race and ethnicity are important factors in responses to environmental exposures, drug therapies, and disease risk, few studies focus on the health needs of racially- and ethnically-diverse aging adults.The objective of this study was to determine the burden of 10 health conditions across race and ethnicity for a nationally-representative sample of aging Americans.Data from the 1998 to 2014 waves of the Health and Retirement Study, an ongoing longitudinal-panel study, were analyzed.

The Longitudinal Associations of Handgrip Strength and Cognitive Function in Aging Americans.

Objectives: Factors that are responsible for age-related neurologic deterioration of noncognitive and cognitive processes may have a shared cause. We sought to examine the temporal, directional associations of handgrip strength and cognitive function in a national sample of aging Americans.

Design: Longitudinal panel.

Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans.

Background: Discovering how certain health factors contribute to functional declines may help to promote successful aging.

Aims: To determine the independent and joint associations of handgrip strength (HGS) and cognitive function with instrumental activities of daily living (IADL) and activities of daily living (ADL) disability decline in aging Americans.

Methods: Data from 18,391 adults aged 50 years and over who participated in at least one wave of the 2006-2014 waves of the Health and Retirement Study were analyzed.

Template matching for benchmarking hospital performance in the veterans affairs healthcare system.

Comparing hospital performance in a health system is traditionally done with multilevel regression models that adjust for differences in hospitals' patient case-mix. In contrast, "template matching" compares outcomes of similar patients at different hospitals but has been used only in limited patient settings.Our objective was to test a basic template matching approach in the nationwide Veterans Affairs healthcare system (VA), compared with a more standard regression approach.

Veterans Affairs patient database (VAPD 2014-2017): building nationwide granular data for clinical discovery.

Background: To study patient physiology throughout a period of acute hospitalization, we sought to create accessible, standardized nationwide data at the level of the individual patient-facility-day. This methodology paper summarizes the development, organization, and characteristics of the Veterans Affairs Patient Database 2014-2017 (VAPD 2014-2017). The VAPD 2014-2017 contains acute hospitalizations from all parts of the nationwide VA healthcare system with daily physiology including clinical data (labs, vitals, medications, risk scores, etc.

Impairments in Individual Autonomous Living Tasks and Time to Self-Care Disability in Middle-Aged and Older Adults.

Objectives: Impairments in specific tasks that are necessary for independent living may identify future self-care limitations, and the use of time-varying covariates can better capture the fluidity in functional capacity trajectories over time. The purpose of this study was to determine the associations between individual instrumental activities of daily living (IADL) impairments and time to activities of daily living (ADL) disability for middle-aged and older adults in the United States.

Design: Longitudinal panel.

Variation in Laboratory Test Naming Conventions in EHRs Within and Between Hospitals: A Nationwide Longitudinal Study.

Background: Electronic health records provide clinically rich data for research and quality improvement work. However, the data are often unstructured text, may be inconsistently recorded and extracted into centralized databases, making them difficult to use for research.

Objectives: We sought to quantify the variation in how key laboratory measures are recorded in the Department of Veterans Affairs (VA) Corporate Data Warehouse (CDW) across hospitals and over time.

Using Veterans Affairs Corporate Data Warehouse to identify 30-day hospital readmissions.

Hospital readmission is a key metric of hospital quality, such as for comparing Veterans Affairs (VA) hospitals to private sector hospitals. To calculate readmission rates, one must first identify individual hospitalizations. However, in the VA Corporate Data Warehouse (CDW), data are organized by "bedded stays," that is, any stay in a healthcare facility where a patient is provided a bed, not hospitalizations.

Handgrip Strength, Function, and Mortality in Older Adults: A Time-varying Approach.

Purpose: To determine the time-varying associations between 1) decreased handgrip strength and disabilities in each activity of daily living (ADL) function, and 2) disaggregated ADL limitations and time to mortality in older adults.

Methods: A United States nationally representative sample of 17,747 older adults from the Health and Retirement Study were followed up for 8 yr. Maximal handgrip strength was measured with a hand-held dynamometer.

Muscle Strength and Functional Limitations: Preserving Function in Older Mexican Americans.

Objectives: Understanding the role of muscle strength as a preventive factor for shorter-term declines in function may provide further insights into the disabling process. This study examined if muscle strength was associated with 2-year preservation of instrumental activities of daily living (IADL) function and activities of daily living (ADL) disability status in older Mexican Americans.

Design: Longitudinal, panel.

Muscle weakness and functional limitations in an ethnically diverse sample of older adults.

Muscle weakness is often linked to functional limitations in older adults. However, certain demographic characteristics, such as ethnicity, may differentially impact the association between weakness and functional limitations. This investigation sought to (1) identify sex- and ethnically-specific muscle weakness thresholds associated with functional limitations among older adults, and (2) determine the odds of functional limitations for each ethnicity by sex after identifying older adults below the weakness thresholds.