Publications by authors named "Helen Sheriff"
Background: Renin-angiotensin system (RAS) inhibitors at higher target doses reduce the risk of death in patients with heart failure with reduced ejection fraction (HFrEF). Less is known about their effectiveness in octogenarians, the examination of which was the objective of this study.
Methods: Of the 32,964 veterans ≥ 80 years with HFrEF (ejection fraction ≤ 40%) receiving RAS inhibitors, 6655 received them at target doses.
Article Synopsis
- - The study investigated how well veterans receiving opioid therapy followed clinical guidelines, comparing those who used only VA services (mono users) to those who also used community care (dual-system users).
- - High overall adherence rates (over 90%) to guidelines were found in both groups, although specific recommendations, like urine drug screening, were less consistently followed (8.9% for mono users, 11.2% for dual users).
- - The study indicated no clear trend in adherence between the two user types but noted an increase in overall guideline adherence from 2015 to 2019, suggesting a need for further research into coordination among dual-system users.
Background: Natural language processing (NLP) can facilitate research utilizing data from electronic health records (EHRs). Large language models can potentially improve NLP applications leveraging EHR notes. The objective of this study was to assess the performance of zero-shot learning using Chat Generative Pre-trained Transformer 4 (ChatGPT-4) for extraction of symptoms and signs, and compare its performance to baseline machine learning and rule-based methods developed using annotated data.
View Article and Find Full Text PDFAims: Heart failure (HF) is a clinical syndrome with no definitive diagnostic tests. HF registries are often based on manual reviews of medical records of hospitalized HF patients identified using International Classification of Diseases (ICD) codes. However, most HF patients are not hospitalized, and manual review of big electronic health record (EHR) data is not practical.
View Article and Find Full Text PDFAims: According to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline, the definition of chronic kidney disease (CKD) requires the presence of abnormal kidney structure or function for >3 months with implications for health. CKD in patients with heart failure (HF) has not been defined using this definition, and less is known about the true health implications of CKD in these patients. The objective of the current study was to identify patients with HF who met KDIGO criteria for CKD and examine their outcomes.
View Article and Find Full Text PDFImpact of the COVID-19 Pandemic on the Provision of Dialysis Service and Mortality in Veterans Receiving Maintenance Hemodialysis in the VA: An Interrupted Time-Series Analysis.
Am J Nephrol
December 2023
Article Synopsis
- The study investigates the effects of the COVID-19 pandemic on outpatient maintenance hemodialysis treatments and mortality rates among Veterans with end-stage kidney disease (ESKD) in the Veterans Health Administration (VHA) system.
- Despite concerns, the analysis shows that the number of hemodialysis treatments remained stable during the pandemic, with an average of 12,865 treatments per month.
- However, there was a notable 2.3% increase in all-cause mortality rates, rising from 17.1 to 19.6 deaths per 1,000 patients per month, indicating a concerning trend for ESKD patients amidst the pandemic.
Article Synopsis
- Cardiorespiratory fitness (CRF) is linked to better overall health and longevity, but its connection to Alzheimer's disease and related dementias (ADRD) is less understood.
- A study involving over 649,000 US veterans analyzed the relationship between CRF levels and the incidence of ADRD over an average follow-up period of about 8 years.
- Results showed that higher CRF levels were associated with a lower risk of developing ADRD, suggesting that improving fitness might help reduce ADRD risk in the future.
Objective: Recent evidence suggests that hydroxychloroquine use is not associated with higher 1-year risk of long QT syndrome (LQTS) in patients with rheumatoid arthritis (RA). Less is known about its long-term risk, the examination of which was the objective of this study.
Methods: We conducted a propensity score-matched active-comparator safety study of hydroxychloroquine in 8,852 veterans (mean age 64 ± 12 years, 14% women, 28% Black) with newly diagnosed RA.
Importance: The US Preventive Services Task Force does not recommend annual lung cancer screening with low-dose computed tomography (LDCT) for adults aged 50 to 80 years who are former smokers with 20 or more pack-years of smoking who quit 15 or more years ago or current smokers with less than 20 pack-years of smoking.
Objective: To determine the risk of lung cancer in older smokers for whom LDCT screening is not recommended.
Design, Settings, And Participants: This cohort study used the Cardiovascular Health Study (CHS) data sets obtained from the National Heart, Lung and Blood Institute, which also sponsored the study.
Article Synopsis
- Beta-blockers have been shown to improve outcomes in patients with heart failure, particularly those with reduced ejection fraction (HFrEF), but their effectiveness in older nursing home residents remains less clear.
- A study analyzed data from nearly 6,500 hospitalized patients aged 65 and over with HFrEF to assess the impact of beta-blockers on mortality and heart failure readmissions, specifically comparing outcomes between nursing home residents and other patients.
- The findings indicated that beta-blocker use was linked to reduced all-cause mortality in older adults, but there was no significant difference in heart failure readmissions, regardless of whether patients were admitted from nursing homes or not.
Article Synopsis
- - The study examined the relationship between heart failure (HF) and breast cancer in postmenopausal women, focusing on whether having one condition affects the likelihood of developing the other.
- - Over a median follow-up period, there was no significant association found between prevalent HF and the incidence of invasive breast cancer, nor vice versa, indicating that having one does not increase the risk of the other in this population.
- - However, the research found that both conditions are linked to higher mortality rates when they occur; women with breast cancer and concurrent HF had worse survival outcomes, and vice versa.
Article Synopsis
- This study investigates the cardiovascular safety of hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA), focusing on its potential to prolong the QT interval, which can lead to serious heart issues.
- The research involved 8,852 US veterans newly diagnosed with RA, comparing outcomes between those treated with HCQ and those receiving other nonbiologic disease-modifying antirheumatic drugs over a 12-month period.
- Results showed a low incidence of long QT syndrome and arrhythmia-related hospitalizations, with no significant evidence suggesting that HCQ therapy increases the risk of cardiovascular problems or mortality in these patients.
Article Synopsis
- Heart failure (HF) is a serious condition that often leads to fluid buildup and difficulty breathing, for which loop diuretics are commonly prescribed; however, their effect on patient outcomes is not fully understood.
- This study analyzed data from over 25,000 older HF patients to explore the association between the use of loop diuretics and clinical outcomes.
- Results indicated that patients who received loop diuretics had a lower 30-day mortality rate and reduced risk of HF readmission compared to those who did not use them, but no significant differences were observed after 60 days.
Article Synopsis
- Racial disparities exist in the incidence of Alzheimer's disease and related dementias (AD/ADRD), but there's limited data specifically concerning Veterans.
- In a study of over 4 million Veterans aged 65 and older, African American Veterans showed a significantly higher incidence of AD/ADRD compared to white Veterans, indicating an alarming trend in this demographic.
- The research highlights the need for further investigation into the reasons behind these disparities, including the role of health predictors like stroke in African Americans and other factors like Hispanic ethnicity and depression in whites.
Article Synopsis
- The study investigated the relationship between hospital length of stay (LoS) and readmission rates in older patients with heart failure, focusing on those hospitalized for decompensated heart failure.
- Among 8,049 patients, those with a LoS greater than 5 days were found to have a higher risk of being readmitted within 30 days and a greater chance of mortality over 8.8 years, although LoS did not correlate with readmissions specifically for heart failure.
- The findings suggest that a longer hospital stay is linked to worse health outcomes, even when excluding patients with extremely long stays (LoS > 10 days).
Article Synopsis
- - Opioid use in older patients hospitalized for heart failure (HF) was studied, revealing that those discharged with opioids had higher all-cause mortality rates compared to those who didn’t receive opioids over an average follow-up of 8.6 years.
- - The study identified distinct differences in mortality risks between hospice and nonhospice patients, with hospice patients on opioids experiencing a significantly higher hazard ratio for mortality.
- - There were also variations in readmission rates, with opioid use linked to increased chances of non-HF related readmissions, while matched hospice patients on opioids did not have any readmissions.
Background: Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs-ARBs) improve outcomes in heart failure (HF). Less is known about this association in nursing home (NH) residents.
Methods: Of the 8024 hospitalized HF patients, 542 were NH residents, of whom 250 received ACEIs-ARBs.
Article Synopsis
- The study investigates the effectiveness of spironolactone, a mineralocorticoid receptor antagonist, in older patients with heart failure and reduced ejection fraction (HFrEF).
- It analyzed data from 8206 patients with HFrEF, comparing those who received spironolactone to those who did not, using matched cohorts based on various characteristics.
- Results indicated that spironolactone showed modest benefits in reducing all-cause mortality and heart failure readmissions in these patients, but the overall effectiveness suggests the need for further strategies to enhance treatment outcomes.
Introduction: Heart failure (HF) is the leading cause of hospital readmission. Medicare home health services provide intermittent skilled nursing care to homebound Medicare beneficiaries. We examined whether discharge home health referral is associated with a lower risk of 30-day all-cause readmission in HF.
View Article and Find Full Text PDFArticle Synopsis
- Digoxin was found to lower the risk of 30-day all-cause readmissions in hospitalized patients with heart failure and reduced ejection fraction (HFrEF) who were treated with β-blockers.
- A study analyzed 3,076 Medicare beneficiaries with HFrEF, identifying a matched cohort of 334 patients comparing those on digoxin versus those not on it, revealing significant differences in readmission rates.
- The results indicated that digoxin not only reduced readmissions at 30 days but also showed lasting benefits over a four-year follow-up, although it did not significantly affect mortality rates.
Background: Digoxin use has been shown to be associated with a lower risk of 30-day all-cause hospital readmissions in older patients with heart failure (HF). In the current study, we examined this association among long-term care (LTC) residents hospitalized for HF.
Methods: Of the 8049 Medicare beneficiaries discharged alive after hospitalization for HF from 106 Alabama hospitals, 545 (7%) were LTC residents, of which 227 (42%) received discharge prescriptions for digoxin.
Article Synopsis
- - The study focused on isolated diastolic hypertension in older adults (≥65 years) and found it to be uncommon but linked to a greater risk of heart failure (HF).
- - In the analysis involving 524 participants, 19% with isolated diastolic hypertension developed HF compared to only 7% without it, highlighting a significant hazard ratio of 4.65.
- - The research concluded that isolated diastolic hypertension, although rare, poses a higher risk for both incident heart failure and cardiovascular mortality among older adults.
Article Synopsis
- The study focuses on isolated systolic hypertension (ISH) and systolic-diastolic hypertension (SDH) in older adults, examining their links to heart failure (HF) and overall health outcomes.
- Using data from 5,776 adults aged 65 and older, the research found that participants with ISH had a higher incidence of HF (25%) compared to those with SDH (22%) and those with no hypertension (11%).
- Both ISH and SDH were found to significantly increase the risk of heart failure and cardiovascular mortality, indicating similar health risks associated with these types of hypertension in older adults.