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Medicare Bundled Payment Policy on Anemia Care, Major Adverse Cardiovascular Events, and Mortality among Adults Undergoing Hemodialysis
CONCLUSIONS: The Medicare reimbursement policy and Food and Drug Administration-recommended erythropoietin-stimulating agent dosing changes were associated with lower erythropoietin-stimulating agent use and lower hemoglobin levels. These changes in anemia care were associated with lower risks of major adverse cardiovascular event, stroke, mortality, and heart failure but higher risk of acute myocardial infarction among adults receiving hemodialysis.PMID:35589388 | DOI:10.2215/CJN.14361121
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 19, 2022 Category: Urology & Nephrology Authors: Haesuk Park Raj Desai Xinyue Liu Steven M Smith Juan Hincapie-Castillo Linda Henry Amie Goodin Saraswathi Gopal Carl J Pepine Raj Mohandas Source Type: research

The impact of surgeon and hospital procedural volume on outcomes after aortic root replacement in the United States
ConclusionAmong Medicare patients undergoing an aortic root replacement, there is a strong inverse relationship between annualized surgeon and hospital case volume and postoperative outcomes. Procedural volume is an important quality metric for this high ‐risk procedure.
Source: Journal of Cardiac Surgery - May 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Chase Brown, Jason Han, Alexandra E. Sperry, Zehang Chen, Fabliha Khurshan, Fenton McCarthy, Joseph E. Bavaria, Peter Groeneveld, Nimesh N. Desai Tags: ORIGINAL ARTICLE Source Type: research

Impact of Complications on Resource Utilization During 90-Day Coronary Artery Bypass Graft Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries who have adverse events during their index CABG hospitalization will significantly affect that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and manage the services consumed by Medicare beneficiaries having adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - April 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - December 14, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries.
CONCLUSIONS: Medicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital's financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care. PMID: 30553739 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 13, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Culler SD, Brown PP, Kugelmass AD, Cohen DJ, Reynolds MR, Katz MR, Schlosser ML, Simon AW Tags: Ann Thorac Surg Source Type: research

Relation of Race, Apparent Disability, and Stroke Risk With Warfarin Prescribing for Atrial Fibrillation in Patients Receiving Maintenance Hemodialysis
We examined patterns of warfarin use, and associated factors, after AF diagnosis. This retrospective cohort analysis studied US Medicare patients receiving maintenance dialysis January 1, 2008-June 30, 2010. Demographics, comorbidity, and a durable medical equipment claims-based disability proxy score predicted warfarin prescription after AF diagnosis. The analysis included 8964 patients with non-valvular AF.
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: James B. Wetmore, Yi Peng, David T. Gilbertson, Jiannong Liu Source Type: research

Safety of Intravenous Iron in Hemodialysis: Longer-term Comparisons of Iron Sucrose Versus Sodium Ferric Gluconate Complex
Conclusions Patients initiating HD therapy in facilities almost exclusively using iron sucrose versus ferric gluconate had similar longer-term outcomes. However, there was a small decrease in infectious hospitalizations and deaths in patients dialyzing in facilities predominantly using iron sucrose. This difference may be due to residual confounding, random chance, or a causal effect.
Source: American Journal of Kidney Diseases - January 4, 2017 Category: Urology & Nephrology Source Type: research

Comparative outcomes of predominant facility-level use of ferumoxytol versus other intravenous iron formulations in incident hemodialysis patients
Conclusions In incident HD patients, ferumoxytol showed similar short- to mid-term safety profiles with regard to cardiovascular, infectious and mortality outcomes compared with the more commonly used intravenous iron formulations IS and FG.
Source: Nephrology Dialysis Transplantation - November 23, 2015 Category: Urology & Nephrology Authors: Airy, M., Mandayam, S., Mitani, A. A., Chang, T. I., Ding, V. Y., Brookhart, M. A., Goldstein, B. A., Winkelmayer, W. C. Tags: Intra- and extracorporeal treatments of kidney failure Source Type: research

A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients
Conclusions: Greater IDWG is associated with an increased risk of CV morbid events. Strategies that mitigate IDWG may improve CV health and survival among hemodialysis patients.
Source: BMC Nephrology - July 22, 2015 Category: Urology & Nephrology Authors: Claudia CabreraSteven BrunelliDavid RosenbaumEmmanuel AnumKarthik RamakrishnanDonna JensenNils-Olov StålhammarBergur Stefánsson Source Type: research

Outcomes After Warfarin Initiation in a Cohort of Hemodialysis Patients With Newly Diagnosed Atrial Fibrillation
Conclusions In hemodialysis patients with incident AF, warfarin use was marginally associated with reduced risk of ischemic stroke, and there was a signal toward reduced mortality in as-treated analyses. These results support clinical equipoise regarding the use of warfarin in hemodialysis patients and underscore the need for randomized trials to fill this evidence gap.
Source: American Journal of Kidney Diseases - July 9, 2015 Category: Urology & Nephrology Source Type: research

Longer-term Outcomes of Darbepoetin Alfa Versus Epoetin Alfa in Patients With ESRD Initiating Hemodialysis: A Quasi-experimental Cohort Study
Conclusions In incident hemodialysis patients, mortality and cardiovascular event rates did not differ between patients treated at facilities predominantly using DPO versus EPO.
Source: American Journal of Kidney Diseases - May 2, 2015 Category: Urology & Nephrology Source Type: research

Use and safety of heparin-free maintenance hemodialysis in the USA
Conclusions Patient markers of increased risk of bleeding and facility region associated with heparin-free HD use. Despite the potential benefits of avoiding heparin use, heparin-free HD was not significantly associated with decreased hazards of death, bleeding or thrombosis, suggesting that it may be no safer than HD with heparin.
Source: Nephrology Dialysis Transplantation - June 18, 2013 Category: Urology & Nephrology Authors: Shen, J. I., Mitani, A. A., Chang, T. I., Winkelmayer, W. C. Tags: Intra- and Extracorporeal Treatment of Kidney Failure Source Type: research