{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:08:43Z","timestamp":1778339323203,"version":"3.51.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Although much attention has been paid to admission and transfer patterns for cardiogenic shock, contemporary data are lacking on decompensated heart failure (HF) admissions and transfers and the impact of advanced therapy centers (ATCs) on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>HF hospitalizations were obtained from the Nationwide Readmissions Database 2016 to 2019. Centers performing at least 1 heart transplant or left ventricular assist device were classified as ATCs. Patient characteristics, outcomes, and procedural volume were compared among 3 cohorts: admissions to non-ATCs, admissions to ATCs, and transfers to ATCs. A secondary analysis evaluated outcomes for severe HF hospitalizations (cardiogenic shock, cardiac arrest, and mechanical ventilation). Multivariable logistic regression was performed to adjust for the presence of HF decompensations and significant clinical variables during univariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 2\u2005331\u2005690 hospitalizations (81.2%) were admissions to non-ATCs (94.5% of centers), 525\u2005037 (18.3%) were admissions to ATCs (5.5% of centers), and 15\u2005541 (0.5%) were transferred to ATCs. Patients treated at ATCs (especially those transferred) had higher rates of HF decompensations, procedural frequency, lengths of stay, and costs. Unadjusted mortality was 2.6% at non-ATCs and was higher at ATCs, both for directly admitted (2.9%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and transferred (11.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) patients. However, multivariable-adjusted mortality was significantly lower at ATCs, both for directly admitted (odds ratio, 0.82 [95% CI, 0.78\u20130.87];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and transferred (odds ratio, 0.66 [95% CI, 0.57\u20130.78];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) patients. For severe HF admissions, unadjusted mortality was 37.2% at non-ATCs and was lower at ATCs, both for directly admitted (25.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and transferred (25.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) patients, with similarly lower multivariable-adjusted mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Patients with HF treated at ATCs were sicker but associated with higher procedural volume and lower adjusted mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.011115","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T05:01:09Z","timestamp":1709874069000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Advanced Therapy Centers on Characteristics and Outcomes of Heart Failure Admissions"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-3956","authenticated-orcid":true,"given":"Daniel Y.","family":"Lu","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."},{"name":"Weill Cornell Cardiovascular Outcomes Research Group, Weill Cornell Medical College, New York (D.Y.L., I.Y., U.K., J.W.C., L.K.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaya","family":"Kanduri","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8825-0757","authenticated-orcid":true,"given":"Ilhwan","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."},{"name":"Weill Cornell Cardiovascular Outcomes Research Group, Weill Cornell Medical College, New York (D.Y.L., I.Y., U.K., J.W.C., L.K.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-3737","authenticated-orcid":true,"given":"Parag","family":"Goyal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-1089","authenticated-orcid":true,"given":"Udhay","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."},{"name":"Weill Cornell Cardiovascular Outcomes Research Group, Weill Cornell Medical College, New York (D.Y.L., I.Y., U.K., J.W.C., L.K.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-9415","authenticated-orcid":true,"given":"Evelyn M.","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8763-6460","authenticated-orcid":true,"given":"Maria G.","family":"Karas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Sobol","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8951-0079","authenticated-orcid":true,"given":"David T.","family":"Majure","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshifumi","family":"Naka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (Y.N.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4424-4528","authenticated-orcid":true,"given":"Robert M.","family":"Minutello","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-9360","authenticated-orcid":true,"given":"Jim W.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York."},{"name":"Weill Cornell Cardiovascular Outcomes Research Group, Weill Cornell Medical College, New York 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