Publications by authors named "In-Lu Amy Liu"
Background: The management of incidental pulmonary nodules is guided by recommendations set forth by the Fleischner Society. While most pulmonary nodules are benign, timely and evidence-based follow-up can reduce morbidity and mortality. There are known socioeconomic disparities for engagement with recommended cancer screenings, however it is unclear whether disparities exist for follow-up of incidentally detected pulmonary lesions.
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- A study investigates the effects of receiving seasonal influenza vaccinations during two successive pregnancies on adverse birth outcomes, focusing on differences based on interpregnancy intervals and vaccine types (quadrivalent or trivalent).
- Data was collected from a large cohort of individuals with at least two singleton live births between 2004 and 2018, using information from the Vaccine Safety Datalink.
- The study analyzed risks of complications like preeclampsia, placental issues, and preterm birth among vaccinated and unvaccinated populations, finding that the majority of participants received vaccinations in both pregnancies.
Key Points: The mean delta anion gap (ΔAG)/delta bicarbonate (ΔHCO) calculated using an albumin-corrected anion gap and each patient's individual baseline AG and serum HCO was 1.20. The ΔAG/ΔHCO using mean normal AG and serum HCO was 1.
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- People with HIV (PWH) are more vulnerable to severe outcomes from COVID-19, but there’s limited knowledge on their vaccination rates and factors influencing their vaccine completion.
- A study was conducted to assess COVID-19 vaccination coverage among PWH and analyze the demographics, clinical aspects, and community influences affecting their vaccination completion.
- Results showed that 90.5% of PWH completed the primary vaccine series by the end of 2021, with prior influenza vaccination being a significant factor for both the initial series and additional doses, while uncontrolled HIV viremia negatively impacted vaccination rates.
Article Synopsis
- COVID-19 vaccinations are effective in preventing severe illness and death but their impact on post-COVID conditions (PCC) is less understood, prompting a study to evaluate this association.
- The study analyzed electronic health records from over 161,000 vaccinated and unvaccinated COVID-19 patients from multiple healthcare systems, focusing on new diagnoses of PCC within six months after infection.
- Results showed that vaccinated individuals had a lower risk of several PCC categories, especially sensory and circulatory issues, while mental health disorders had a slightly higher risk in vaccinated individuals, indicating that vaccination may help reduce long-term COVID-19 consequences.
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.
Importance: After SARS-CoV-2 infection, many patients present with persistent symptoms for at least 6 months, collectively termed post-COVID conditions (PCC). However, the impact of PCC on health care utilization has not been well described.
Objectives: To estimate COVID-19-associated excess health care utilization following acute SARS-CoV-2 infection and describe utilization for select PCCs among patients who had positive SARS-CoV-2 test results (including reverse transcription-polymerase chain reaction and antigen tests) compared with control patients whose results were negative.
Background: Shoulder injury related to vaccine administration (SIRVA) accounts for more than half of all claims received by the National Vaccine Injury Compensation Program. However, due to the difficulty of finding SIRVA cases in large health care databases, population-based studies are scarce.
Objective: The goal of the research was to develop a natural language processing (NLP) method to identify SIRVA cases from clinical notes.
Article Synopsis
- - The study explores the risk of shoulder conditions following intramuscular vaccinations, particularly in the deltoid muscle, using data from Kaiser Permanente Southern California between April 2016 and December 2017.
- - Out of over 3.7 million vaccinations, only 371 cases of shoulder conditions were identified, leading to an estimated incidence rate of 0.99 per 10,000 vaccinations, with higher risks noted in adults, especially women and older individuals.
- - Factors associated with increased risk included advanced age, female sex, specific vaccines, and simultaneous administration of vaccines among the elderly, indicating that certain populations may be more vulnerable to these shoulder issues post-vaccination.
Background: To assess 12-year outcomes on radical prostatectomy with T3/positive margins, while categorizing patients into risk groups.
Methods: From 2004 to 2007, 862 radical prostatectomy patients had T3/positive margins. Management included surveillance (54.
Safety of Influenza Vaccination During Orthopaedic Surgery Hospitalizations.
J Am Acad Orthop Surg
January 2022
Background: Despite national recommendations, influenza vaccination rates during hospitalizations remain low. Inpatient hospitalization for orthopaedic surgery remains a largely missed opportunity for vaccination. To address potential concerns regarding safety, we evaluated whether influenza vaccination during hospitalization for orthopaedic surgery increases evaluations for infection postdischarge because patients and clinicians often cite fear of this potential outcome.
View Article and Find Full Text PDFBackground: No prior studies have examined the effects of home-based primary care (HBPC) in persons living with dementia (PLWD), within an ecosystem of serious illness care in an integrated healthcare system. Our objectives were to compare the characteristics of PLWD receiving HBPC and their hospital utilization and end-of-life care, with those of a matched comparison group, and to understand the experiences of family caregivers of PLWD receiving HBPC.
Methods: This mixed-methods study used a retrospective observational cohort design with PLWD receiving HBPC (n = 287) from 2015 to 2020 and a strata-matched comparison group (n = 861), and qualitative phone interviews with 16 HBPC family caregivers in 2020.
Background: The frequency of cancer and accuracy of prediction models have not been studied in large, population-based samples of patients with incidental pulmonary nodules measuring > 8 mm in diameter.
Research Questions: How does the frequency of cancer vary by size and smoking history among patients with incidental nodules? How accurate are two widely used models for identifying cancer in these patients?
Study Design And Methods: We assembled a retrospective cohort of individuals with incidental nodules measuring > 8 mm in diameter identified by chest CT imaging between 2006 and 2016. We used a validated natural language processing algorithm to identify nodules and their characteristics by scanning the text of dictated radiology reports.
Introduction: Major efforts to increase influenza vaccine uptake among Kaiser Permanente Southern California (KPSC) members have been undertaken in recent years. However, whether these improvements translate to a decline in severe influenza-related outcomes has not been examined. We aimed to understand the impact of the influenza vaccination program at KPSC by examining influenza vaccine uptake and 3 severe influenza-related outcomes.
View Article and Find Full Text PDFBackground: Limited studies have explored post-discharge outcomes following Coronavirus Disease 2019 (COVID-19) hospitalisation. We sought to characterise patients discharged following a COVID-19 hospitalisation within a large integrated health system in the United States.
Methods: We performed a retrospective study of 2180 COVID-19 patients discharged between 1 April 2020 and 31 July 2020.
Importance: While observational studies show that physical inactivity is associated with worse outcomes in chronic obstructive pulmonary disease (COPD), there are no population-based trials to date testing the effectiveness of physical activity (PA) interventions to reduce acute care use or improve survival.
Objective: To evaluate the long-term effectiveness of a community-based PA coaching intervention in patients with COPD.
Design, Setting, And Participants: Pragmatic randomized clinical trial with preconsent randomization to the 12-month Walk On! (WO) intervention or standard care (SC).
Objectives: The current evidence base regarding the effectiveness of home-based palliative care (HomePal) on outcomes of importance to multiple stakeholders remains limited. The purpose of this study was to compare end-of-life care in decedents who received HomePal with two cohorts that either received hospice only (HO) or did not receive HomePal or hospice (No HomePal-HO).
Design: Retrospective cohorts from an ongoing study of care transition from hospital to home.
Risk factors for medication non-adherence among atrial fibrillation patients.
BMC Cardiovasc Disord
February 2019
Article Synopsis
- A research study focused on patients with atrial fibrillation (AF) aimed to identify factors contributing to medication non-adherence within a diverse population in California.
- The study analyzed data from over 12,000 AF patients, revealing that 6.3% reported not following their prescribed medication regimen, with various socio-demographic and health-related factors influencing this behavior.
- Key risk factors for non-adherence included being from a minority ethnic background, being unmarried, being physically inactive, experiencing poor health days, having memory issues, low health literacy, and having diabetes.
Objective: To determine whether influenza vaccination during hospitalization increases health care utilization, fever, and infection evaluations postdischarge.
Patients And Methods: This retrospective cohort study conducted at Kaiser Permanente Southern California included patients aged 6 months or older hospitalized in a Kaiser Permanente Southern California facility with admission and discharge dates between September 1 and March 31 of the following calendar year, from 2011 to 2014. All influenza vaccinations administered during the period of August 1 to April 30 for influenza seasons 2011-2012, 2012-2013, and 2013-2014 were identified.
Article Synopsis
- The study investigates how inpatient palliative care (IPC) impacts the quality of end-of-life care and healthcare usage among patients who died between 2012 and 2014 in Kaiser Permanente Southern California.
- Patients who received IPC were more likely to enroll in home-based palliative care or hospice and were less likely to die in hospitals or intensive care units compared to those who did not receive IPC.
- However, those receiving IPC had a higher chance of being rehospitalized and visiting emergency departments, suggesting that increased healthcare utilization may be influenced by existing patient needs rather than the care itself.
Background: Atrial fibrillation (AF) is the most common clinically significant arrhythmia in adults and a major risk factor for ischemic stroke. Nonetheless, previous research suggests that many individuals diagnosed with AF lack awareness about their diagnosis and inadequate health literacy may be an important contributing factor to this finding.
Methods And Results: We examined the association between health literacy and awareness of an AF diagnosis in a large, ethnically diverse cohort of Kaiser Permanente Northern and Southern California adults diagnosed with AF between January 1, 2006 and June 30, 2009.
The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD) hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011.
View Article and Find Full Text PDFBackground: The comparative effectiveness of surgical and medical treatments on fracture risk in primary hyperparathyroidism (PHPT) is unknown.
Objective: To measure the relationship of parathyroidectomy and bisphosphonates with skeletal outcomes in patients with PHPT.
Design: Retrospective cohort study.