Carson T. Moss

All Publications

• Home Hospital Outcomes for Acute Decompensated Heart Failure and Factors Associated With Escalation of Care. Circulation. Cardiovascular quality and outcomes Achanta, A., Wasfy, J. H., Moss, C. T., Cherukara, A., Ho, D., Boxer, R., Schmieding, M., Phadke, N. A., Thompson, R., Levine, D. M., Weiner, R. B. 2023: e010031

  Abstract

  BACKGROUND: Overall outcomes and the escalation rate for home hospital admissions for heart failure (HF) are not known. We report overall outcomes, predict escalation, and describe care provided after escalation among patients admitted to home hospital for HF.METHODS: Our retrospective analysis included all patients admitted for HF to 2 home hospital programs in Massachusetts between February 2020 and October 2022. Escalation of care was defined as transfer to an inpatient hospital setting (emergency department, inpatient medical unit) for at least 1 overnight stay. Unexpected mortality was defined as mortality excluding those who desired to pass away at home on admission or transitioned to hospice. We performed the least absolute shrinkage and selection operator logistic regression to predict escalation.RESULTS: We included 437 hospitalizations; patients had a median age of 80 (interquartile range, 69-89) years, 58.1% were women, and 64.8% were White. Of the cohort, 29.2% had reduced ejection fraction, 50.9% had chronic kidney disease, and 60.6% had atrial fibrillation. Median admission Get With The Guidelines HF score was 39 (interquartile range, 35-45; 1%-5% predicted inpatient mortality). Escalation occurred in 10.3% of hospitalizations. Thirty-day readmission occurred in 15.1%, 90-day readmission occurred in 33.8%, and 6-month mortality occurred in 11.5%. There was no unexpected mortality during home hospitalization. Patients who experienced escalation had significantly longer median length of stays (19 versus 7.5 days, P<0.001). The most common reason for escalation was progressive renal dysfunction (36.2%). A low mean arterial pressure at the time of admission to home hospital was the most significant predictor of escalation in the least absolute shrinkage and selection operator regression.CONCLUSIONS: About 1 in 10 home hospital patients with HF required escalation; none had unexpected mortality. Patients requiring escalation had longer length of stays. A low mean arterial pressure at the time of admission to home hospital was the most important predictor of escalation of care in the least absolute shrinkage and selection operator logistic regression model.

  View details for DOI 10.1161/CIRCOUTCOMES.123.010031

  View details for PubMedID 38054286

• Caregiver burden in a home hospital versus traditional hospital: A secondary analysis of a randomized controlled trial. Journal of the American Geriatrics Society Moss, C. T., Schnipper, J. L., Levine, D. M. 2023

  View details for DOI 10.1111/jgs.18603

  View details for PubMedID 37789659

• The Reply. The American journal of medicine Barkoudah, E., Moss, C., Connell, N. T. 2023; 136 (3): e56

  View details for DOI 10.1016/j.amjmed.2022.11.011

  View details for PubMedID 36796962

• Occam's Razor for Severe B12 Deficiency. The American journal of medicine Moss, C., Patil, D. T., Connell, N. T., Zon, R. L., Barkoudah, E. 2022; 135 (7): 844-847

  View details for DOI 10.1016/j.amjmed.2022.01.039

  View details for PubMedID 35139322