Publications by authors named "Christopher Subject"
Background: The effectiveness and safety of mineralocorticoid receptor antagonists (MRA) in acute heart failure (HF) is uncertain. We sought to describe the prescription of spironolactone during acute HF and whether early treatment is effective and safe in a real-world setting.
Methods: We performed a retrospective cohort study of adult (≥18 years) nonpregnant patients hospitalized with new-onset HF with reduced ejection fraction (HFrEF, defined by ejection fraction ≤40%) within 15 Kaiser Permanente Southern California medical centers between 2016 and 2021.
Article Synopsis
- In a study examining newly diagnosed heart failure patients, researchers found that coronary artery disease (CAD) testing is not commonly used, despite its potential benefits.
- The study analyzed data from 2729 hospitalized patients with HFrEF and found that those who underwent CAD testing had a significantly lower risk of hospital readmission or death over a follow-up period.
- However, the timing of the testing (early vs. late) did not influence the outcomes, suggesting that testing within 90 days of hospitalization is valuable regardless of when it occurs.
Article Synopsis
- Researchers developed the COVID Hospitalized Patient Deterioration Index (COVID-HDI) to better predict serious health declines in hospitalized COVID-19 patients, improving on an existing model not tailored for respiratory issues related to the virus.
- The study involved analyzing data from COVID patients at Kaiser Permanente Southern California, applying machine learning techniques and various predictors to create an effective model for identifying high-risk patients.
- With a high accuracy rate (0.83) and the ability to classify 74% of patients as low-risk during hospitalization, COVID-HDI aids in clinical decisions regarding patient discharge and care escalation.
Background: Understanding the implications of disease-specific factors beyond baseline patient characteristics for coronavirus disease 2019 (COVID-19) may allow for identification of indicators for safe hospital discharge.
Objective: Assess whether disease-specific factors are associated with adverse events post-discharge using a data-driven approach.
Design: Retrospective cohort study.
Importance: Current guidelines recommend use of dexamethasone, 6 mg/d, up to 10 days or until discharge for patients hospitalized with COVID-19. Whether patients who received less than 10 days of corticosteroids during hospitalization for COVID-19 benefit from continuing treatment at discharge has not been determined.
Objective: To assess whether continuing dexamethasone treatment at discharge is associated with reduced all-cause readmissions or mortality postdischarge.
Background: The demands for healthcare resources following a COVID-19 diagnosis are substantial, but not currently quantified.
Objective: To describe trends in healthcare utilization within 180 days for patients diagnosed with COVID-19 and identify patient factors associated with increased healthcare use.
Design: Observational cohort study.
Objective: Develop and validate a risk score using variables available during an Emergency Department (ED) encounter to predict adverse events among patients with suspected COVID-19.
Methods: A retrospective cohort study of adult visits for suspected COVID-19 between March 1 - April 30, 2020 at 15 EDs in Southern California. The primary outcomes were death or respiratory decompensation within 7-days.