Publications by authors named "Karen S Ream"
Background: Females have historically lower rates of cardiovascular testing when compared to males. Clinical decision pathways (CDP) that utilize standardized risk-stratification methods may balance this disparity. We sought to determine whether clinical decision pathways could minimize sex-based differences in the non-invasive workup of chest pain in the emergency department (ED).
View Article and Find Full Text PDFBackground: Serum troponin levels correlate with the extent of myocyte necrosis in acute myocardial infarction (AMI) and predict adverse outcomes. However, thresholds of cardiac troponin elevation that could portend to poor outcomes have not been established.
Methods: In this cohort study, we characterized all cardiac troponin elevations > 0.
Article Synopsis
- - The study analyzes two Medicare payment programs for treating acute myocardial infarction (AMI) using different classification methods: the Hospital Readmissions Reduction Program (using ) codes) and the Bundled Payments for Care Improvement Advanced (using diagnosis-related groups, or DRGs).
- - Among 2,176 patients, only 19.3% were common to both cohorts, with DRG patients being older, more often female, and having higher rates of heart and kidney diseases; they also experienced higher mortality and readmission rates compared to the AMI cohort.
- - The findings indicate that the choice of classification method significantly impacts patient demographics and outcomes, highlighting the need for careful consideration in quality assessment initiatives.