JACC. Heart failure
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JACC. Heart failure · Oct 2017
Variation in Do-Not-Resuscitate Orders and Implications for Heart Failure Risk-Adjusted Hospital Mortality Metrics.
This study evaluated the effect of patient do-not-resuscitate (DNR) status on hospital risk-adjusted heart failure mortality metrics. ⋯ Accounting for DNR status resulted in a change in estimated risk-standardized mortality rates and classification of hospitals as performance "outliers." Given public reporting of heart failure mortality measurements and their influence on reimbursement, accounting for the presence of early DNR orders in quality measures should be considered.
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JACC. Heart failure · Oct 2017
Impact of Center Left Ventricular Assist Device Volume on Outcomes After Implantation: An INTERMACS Analysis.
This study examined patient outcomes after left ventricular assist device (LVAD) implantation across a range of center surgical volumes. ⋯ Center volume correlates with post-VAD survival, with worse survival noted at very-low volume centers. These findings suggest that current U.S. VAD center standards warrant reconsideration.