Staten Island University Hospital (SIUH) is a member hospital of Northwell Health. It is a major tertiary referral center in Staten Island, New York City.SIUH is a two-campus, 668-bed specialized teaching hospital. Occupying two large campuses, plus a number of community-based health centers and labs, the hospital provides care to the people of Staten Island and the New York metropolitan region.
Upper gastrointestinal bleeding (UGIB) remains a significant clinical emergency with substantial mortality. Accurate risk stratification is essential for optimal patient triage and management. The ABC score (Age, Blood tests, Comorbidities) and AIMS65 score are prominent pre-endoscopy risk stratification tools, yet direct comparative studies within diverse United States healthcare populations remain limited. To compare the predictive accuracy of ABC and AIMS65 scores for in-hospital mortality and secondary clinical outcomes in patients with acute UGIB. This retrospective cohort study analyzed 2,009 adult patients admitted with acute UGIB across multiple Northwell Health hospitals between January 2019 and January 2024. Both ABC and AIMS65 scores were calculated for each patient using structured EMR data, ICD-10 diagnosis codes, and anesthesiology procedure documentation. Primary outcomes included in-hospital mortality and 30-day readmission. Secondary outcomes encompassed hospital length of stay, ICU admission, development of complications (shock, sepsis, acute kidney injury), vasopressor use, and need for mechanical ventilation. Univariable logistic regression models assessed predictive accuracy using area under the receiver operating characteristic curve (AUC), with bootstrap internal validation (10,000 resamples) confirming negligible optimism bias. DeLong’s test compared discriminative abilities between scores. Sensitivity analyses evaluated score performance across pandemic periods and in a broader AIMS65-computable cohort. Among 2,009 patients (56.1
The Dual chamber leadless pacemaker (DC-LP, Aveir DR) system introduces a pivotal innovation in pacing by enabling dual-chamber synchronization in a completely self-contained system. This was a retrospective, single-center study that included consecutive 102 patients who underwent implantation of the dual-chamber leadless pacemaker system at Staten Island University Hospital between January 2024 and February 2025. Procedural and electrical outcomes were assessed at implant, 1–3 months and 3–6 months follow-up. The study cohort included 102 patients with a mean age of 77.3 ± 10 years, and a male predominance (57.8
Abstract Introduction Elevated pulmonary vascular resistance (PVR) is a known risk factor for right ventricular failure and mortality following heart transplantation. However, the optimal PVR threshold for risk stratification remains undefined in the era of the HeartMate 3 (HM3) left ventricular assist device (LVAD), which offers superior hemocompatibility compared to prior generations. Methods We analyzed the UNOS registry for adult heart transplant recipients (2018–2024) bridged with a durable HM3 LVAD. The primary endpoint was post-transplant mortality. An iterative log-rank optimization analysis was performed to identify the PVR cutoff that maximally stratified survival. A multivariable Cox proportional hazards model was constructed to assess independence from confounders, including UNOS listing status. Results The final cohort comprised 3,003 patients. The optimal PVR threshold was identified at 3.25 Wood Units (WU). Patients in the High PVR group (≥ 3.25 WU, n=329) had significantly higher mortality than the Low PVR group (< 3.25 WU) at 30 days (7.0% vs. 4.0%, p=0.015) and 3 years (19.1% vs. 13.7%, p=0.010). In multivariable analysis, PVR ≥ 3.25 WU remained a significant independent predictor of mortality (HR 1.31, 95% CI 1.02–1.70, p=0.034). Notably, High Acuity Listing Status (Status 1 or 2) was not independently associated with survival (p=0.110) after adjustment. Conclusion In the HeartMate 3 era, pre-transplant PVR ≥ 3.25 WU is a robust independent predictor of post-transplant mortality, distinct from clinical acuity. This threshold offers a novel, physiological benchmark for risk stratification, suggesting that residual pulmonary hypertension requires targeted management even in patients supported by contemporary centrifugal-flow devicesFor image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.
