Publications by authors named "Ilhwan Yeo"
Aims: Utilization of transvenous lead extraction/removal (TLE) for the management of cardiac implantable electronic device (CIED)-associated infective endocarditis (IE) remains low. The aim of this study was to examine the impact of hospital TLE procedural volume on TLE utilization and outcomes for patients with CIED-associated IE.
Methods And Results: Using the Nationwide Readmissions Database, we evaluated 21 545 admissions for patients (mean age 70 years, 39% female) with CIEDs hospitalized with IE at TLE centres.
Sex Disparities in the Management, Outcomes, and Transfer of Patients Hospitalized for Cardiogenic Shock.
J Soc Cardiovasc Angiogr Interv
March 2024
Article Synopsis
- Previous studies indicated that women experience worse outcomes than men when suffering from cardiogenic shock (CS), especially when treated at less advanced hospitals (spokes) compared to specialized centers (hubs).
- An analysis of over 618,000 hospitalizations revealed that women were less likely to be transferred to hubs, underwent fewer invasive procedures, and had higher in-hospital mortality rates compared to men.
- Findings suggest a need for further research to address the sex disparities in treatment and outcomes for women with cardiogenic shock, as they face greater challenges in receiving optimal care.
Background: Although much attention has been paid to admission and transfer patterns for cardiogenic shock, contemporary data are lacking on decompensated heart failure (HF) admissions and transfers and the impact of advanced therapy centers (ATCs) on outcomes.
Methods: HF hospitalizations were obtained from the Nationwide Readmissions Database 2016 to 2019. Centers performing at least 1 heart transplant or left ventricular assist device were classified as ATCs.
Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for patients with cardiogenic shock. Although Impella or intra-aortic balloon pump (IABP) is frequently used for left ventricular unloading (LVU) during VA-ECMO treatment, there are limited data on comparative outcomes. We compared outcomes of Impella and IABP for LVU during VA-ECMO.
View Article and Find Full Text PDFFeasibility and Safety of Impella-Assisted High-Risk PCI Before TAVR in Patients With Severe Aortic Stenosis.
J Soc Cardiovasc Angiogr Interv
June 2023
Background: There are limited data on the feasibility of Impella-assisted percutaneous coronary intervention (PCI) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
Methods: To assess the feasibility of the Impella-assisted PCI in patients with severe symptomatic AS, we retrospectively reviewed the medical records to identify patients who were electively admitted for Impella-assisted PCI with a subsequent TAVR at Weill Cornell Medical Center from 2016 to 2021.
Results: During the study period, 15 patients were identified to be eligible for the study, but the Impella failed to cross the aortic valve in 1 patient despite a concomitant balloon aortic valvuloplasty requiring a switch to an intra-aortic balloon pump to assist PCI.
Article Synopsis
- Cardiac implantable electronic device (CIED)-associated infections can lead to serious health issues and increased medical costs, with endocarditis being a key reason for recommending lead removal/extraction (TLE) in patients.
- A study analyzed data from over 25,000 hospital admissions involving CIEDs and endocarditis from 2016 to 2019, revealing that only 11.5% underwent TLE, but this rate increased significantly during the study period.
- Despite being associated with lower mortality rates (6.0% for TLE vs. 9.5% without), several factors, including age and certain health conditions, hindered the likelihood of patients receiving TLE, indicating a need to address
Objective: The proportion of ST-segment elevation myocardial infarction (STEMI) patients without standard modifiable risk factors (SMuRFs: hypertension, diabetes, hypercholesterolemia and smoking) has increased over time. The absence of SMuRFs is known to be associated with worse outcomes, but its association with age and sex is uncertain. We sought to evaluate the association between age and sex with the outcomes of post-STEMI patients without SMuRFs among patients without preexisting coronary artery disease.
View Article and Find Full Text PDFArticle Synopsis
- * Women faced a greater burden of comorbidities and were less likely to receive key therapeutic interventions, such as coronary angiography, during their hospital stay.
- * Although women had higher crude fatality rates post-cardiac arrest, this did not translate to independent increased risk when accounting for their baseline health differences, indicating that readmission risk is influenced by multiple factors.
Article Synopsis
- Clostridium difficile infection (CDI) is a major healthcare-associated issue in the U.S., with rising threats noted particularly in older populations from 2003 to 2014.
- Analysis of national inpatient data showed that while the overall CDI prevalence remained stable, mortality rates significantly decreased from 2008 to 2014, despite an initial increase in severity from 2003 to 2008.
- Notably, younger patients increasingly made up a larger portion of CDI cases, prompting a need for more research to understand the factors behind these trends and improve prevention strategies.
The association between malignancy and readmission after Takotsubo syndrome (TTS) hospitalization has not been fully described. We sought to examine the rates, cause, and cost of 30-day readmissions of TTS, with or without malignancy, by utilizing Nationwide Readmissions Databases from 2010 to 2014. We identified 61,588 index hospitalizations for TTS.
View Article and Find Full Text PDFAlthough abdominal aortic aneurysms (AAA) are more common in men, women with AAA have increased morbidity and mortality. Additionally, there are discrepancies among professional society guidelines for AAA screening in women. In this retrospective study from the Nationwide Inpatient Sample (NIS) database from 2003 to 2014, we compared rates of AAA repair (rupture and elective) and AAA-related mortality in men vs.
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- Cardiogenic shock (CS) has high mortality rates, and there's a shift towards using regional hubs to improve patient care, but there's little data on outcomes from these hubs.
- A study analyzed CS hospitalizations from 2010-2014 to compare mortality rates between hospitals classified as 'hubs' (which receive transfers) and 'spokes' (without transfers), finding lower mortality rates in hubs for both direct admissions and transfers.
- Treatment at hub hospitals involved more procedures, longer stays, and higher costs, but significantly reduced mortality rates for patients admitted directly or transferred there.
Background: Pseudo-Wellens syndrome is a rare entity characterized by the presence of electrocardiogram (ECG) changes of Wellens syndrome but without the stenosis of the left anterior descending (LAD) coronary artery. In previous reports, pseudo-Wellens syndrome most commonly resulted from recreational drug use or unidentified etiologies. We present a unique case of pseudo-Wellens syndrome due to sepsis-induced cardiomyopathy and a review of the literature.
View Article and Find Full Text PDFA Sleep Hygiene Intervention to Improve Sleep Quality for Hospitalized Patients.
Jt Comm J Qual Patient Saf
June 2021
Introduction: Poor sleep is a pervasive problem for hospitalized patients and can contribute to adverse health outcomes.
Methods: We aimed to improve self-reported sleep for patients on a general medicine ward as measured by the Richards-Campbell Sleep Questionnaire (RCSQ) as well as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question addressing quietness at night. We utilized a non-pharmacologic sleep hygiene bundle composed of a short script with sleep hygiene prompts, such as whether patients would like the shades closed or the lights turned off, as well as a sleep package including an eye mask, earplugs, lavender scent pad, and non-caffeinated tea.
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- Cardiovascular disease is the top cause of death among women in the U.S., and revascularization is a standard treatment for STEMIs that typically lowers readmission rates.
- * The study analyzed data from STEMI hospitalizations (2010-2014) to explore sex differences in revascularization rates and 30-day readmission rates.
- * Results showed that women had lower rates of revascularization and higher readmission rates compared to men, with heart failure being the primary cause of readmission for women even after revascularization.
Background The independent prognostic value of troponin and other biomarker elevation among patients with coronavirus disease 2019 (COVID-19) are unclear. We sought to characterize biomarker levels in patients hospitalized with COVID-19 and develop and validate a mortality risk score. Methods and Results An observational cohort study of 1053 patients with COVID-19 was conducted.
View Article and Find Full Text PDFBackground Readmission after ST-segment-elevation myocardial infarction (STEMI) poses an enormous economic burden to the US healthcare system. There are limited data on the association between length of hospital stay (LOS), readmission rate, and overall costs in patients who underwent primary percutaneous coronary intervention for STEMI. Methods and Results All STEMI hospitalizations were selected in the Nationwide Readmissions Database from 2010 to 2014.
View Article and Find Full Text PDFInpatient hospital procedural volume and outcomes following catheter ablation of atrial fibrillation.
J Cardiovasc Electrophysiol
August 2020
Article Synopsis
- The study investigates how the volume of atrial fibrillation (AF) ablation procedures at hospitals affects patient outcomes, focusing on complications and readmission rates between 2010 and 2014.
- It found that the majority of hospitals performing AF ablations (79.3%) were low volume centers, which showed higher complication and early mortality rates compared to higher volume hospitals.
- Patients at low volume hospitals tended to be older and had more associated health issues, leading to significantly poorer outcomes such as increased risks of cardiac perforation and mortality.
Risk of Mortality Following Catheter Ablation of Atrial Fibrillation.
J Am Coll Cardiol
November 2019
Article Synopsis
- The study investigates early mortality rates after catheter ablation for atrial fibrillation (AF), using a large database of patient admissions from 2010 to 2015.
- Early mortality was found to be 0.46%, with over half of the deaths happening during readmission within 30 days after the procedure.
- Key factors linked to early mortality include procedural complications, congestive heart failure, and low hospital experience with AF ablation procedures.
This cohort study investigates the rate, timing, and causes of hospital readmission after cardiac arrest and the risk factors associated with readmission.
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- - The study investigates how the number of MitraClip procedures performed at hospitals affects patient outcomes after the surgery, classifying hospitals into low, medium, and high-volume categories based on annual procedures.
- - Data from 2014 to 2015 involving 3,420 MitraClip procedures was analyzed, revealing that low-volume hospitals (≤3 procedures/year) had significantly higher rates of in-hospital mortality and complications compared to high-volume hospitals (≥14 procedures/year).
- - The findings indicate that lower hospital volume is linked to worse outcomes, including higher rates of in-hospital deaths, 90-day readmissions, and infections, suggesting that patients may benefit from surgery at higher-volume centers.
Article Synopsis
- Catheter ablation for atrial fibrillation (AF) shows significant sex-based differences, with women experiencing higher rates of complications and readmissions compared to men.
- A study of over 54,000 patients revealed that 37.7% were female, and women had increased risks for complications, including cardiac perforation and bleeding.
- Despite these complications, the overall costs of AF ablation were lower for women due to less resource usage, highlighting the need for further exploration of sex disparities in AF management.
Article Synopsis
- Patients undergoing catheter ablation for ventricular tachycardia (VT) after myocardial infarction face high in-hospital complication rates (11.5%) and a 30-day readmission rate of 19.2%.
- Major predictors of these readmissions include pre-existing conditions like pulmonary hypertension, congestive heart failure, and chronic lung disease.
- Readmissions contribute significantly to increased hospitalization costs, with cardiac issues being the leading cause, particularly recurrent VT and congestive heart failure.