Related Experiment Video

Updated: Oct 28, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.6K

Cardiac Transitional Care Effectiveness: Does Overall Comorbidity Burden Matter?

Joshua Garfein1, George Cholack2, Rachel Krallman1

  • 1Michigan Medicine, Ann Arbor.

The American Journal of Medicine
|July 17, 2021
PubMed

Insights

Transitional care programs like BRIDGE reduce hospital readmissions for cardiac patients with fewer comorbidities. Those with multiple health issues may require different care approaches for similar benefits.

Area of Science:

  • Cardiology
  • Healthcare Management
  • Patient Outcomes

Background:

  • Cardiovascular disease is a leading cause of death and hospitalization in the US.
  • Transitional care programs can improve cardiac patient outcomes.
  • The differential effectiveness of these programs based on patient comorbidity burden is not well understood.

Purpose of the Study:

  • To evaluate the effectiveness of the Bridging the Discharge Gap Effectively (BRIDGE) program.
  • To assess if cardiac patients with varying Charlson Comorbidity Index (CCI) scores benefit equally from transitional care.
  • To determine the impact of the BRIDGE program on adverse clinical outcomes.

Main Methods:

  • A cohort of 4559 cardiac patients discharged between 2008 and 2017 was studied.
  • Proportional hazards regression models analyzed the association between BRIDGE attendance and outcomes.
  • Interaction between BRIDGE attendance and CCI was assessed for hospital readmission, emergency department (ED) visits, and a composite endpoint (readmission, ED visit, or mortality).

Main Results:

  • BRIDGE attendance was associated with lower hospital readmission and composite endpoint risk in patients with low CCI.
  • The positive associations of BRIDGE attendance were significantly weaker in patients with high CCI.
  • Overall, BRIDGE attendance reduced the composite endpoint hazard by 11%.

Conclusions:

  • Transitional care clinic attendance is inversely associated with readmission risk in cardiac patients with low comorbidity burden.
  • The effectiveness of transitional care may vary based on a patient's comorbidity index.
  • Further research is needed to develop tailored transitional care programs for patients with diverse comorbidity profiles.
Abstract

Keywords:
All-cause mortalityCharlson comorbidity indexMidlevel providersReadmissionsTransitional care

More Related Videos

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program04:24

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Published on: April 19, 2019

12.0K
Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

3.9K

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
74
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
65
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
91
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
66
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
57
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
102