National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
- (-) Adverse Events (10)
- Children/Adolescents (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Healthcare-Associated Infections (HAIs) (3)
- Hospitalization (1)
- Hospital Readmissions (1)
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- Medication: Safety (2)
- Opioids (1)
- (-) Orthopedics (10)
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- Quality of Care (1)
- Risk (3)
- Shared Decision Making (1)
- Surgery (10)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedHerzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Eisenberg MT, Block AM, Vopat ML
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
This study’s objective was to describe and analyze the rates of surgical site infections after anterior cruciate ligament (ACL) surgery in pediatric patients. The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to access data for privately insured individuals aged 5 to 30 years old. ACL reconstruction operation records were accessed for operations performed from 2006 to 2018. The database identified 44,501 individuals up to 18 years old, and 63,495 individuals aged 18 to 30 years old that underwent arthroscopic ACL reconstruction. No differences in infection rates were found between the two groups. However, among patients younger than 18 years, patients below 15 years old had a significantly lower infection rate at 0.37% compared with adolescents 15 to 17 years old at 0.55%. Among young adults, males had a higher infection rate than females, while no differences were observed in the pediatric and adolescent population.
AHRQ-funded; HS019455.
Citation: Eisenberg MT, Block AM, Vopat ML .
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
J Pediatr Orthop 2022 Apr;42(4):e362-e66. doi: 10.1097/bpo.0000000000002080..
Keywords: Children/Adolescents, Surgery, Orthopedics, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds
Fatemi P, Zhang Y, Han SS
A, et al. External validation of a predictive model of adverse events following spine surgery.
The authors externally validated a previously developed predictive model for common 30-day adverse events after spine surgery, the Risk Assessment Tool for Adverse Events after Spine Surgery (RAT-Spine). Their results are presented as low-, moderate-, and high-risk designations.
AHRQ-funded; HS023800.
Citation: Fatemi P, Zhang Y, Han SS .
A, et al. External validation of a predictive model of adverse events following spine surgery.
Spine J 2022 Jan;22(1):104-12. doi: 10.1016/j.spinee.2021.06.006..
Keywords: Surgery, Adverse Events, Orthopedics, Risk
Halawi MJ, Gronbeck C, Metersky ML
AHRQ Author: Eldridge N
Time trends in patient characteristics and in-hospital adverse events for primary total knee arthroplasty in the United States: 2010-2017.
This study looked at trends in patient characteristics and in-hospital adverse events (AEs) for primary total knee arthroplasty (TKA) from 2010 to 2017. A total of 14,057 primary TKAs captured by the Medicare Patient Safety Monitoring System was retrospectively reviewed. Risk factors that increased included obesity prevalence, tobacco smoking, and renal disease. There were reductions in coronary artery disease and chronic warfarin use. Inpatient AEs decreased from 4.9% to 2.5%, primarily driven by reductions in anticoagulant-associated AEs, including major bleeding and hematomas, catheter-associated urinary tract infections, pressure ulcers, and venous thromboembolism.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Halawi MJ, Gronbeck C, Metersky ML .
Time trends in patient characteristics and in-hospital adverse events for primary total knee arthroplasty in the United States: 2010-2017.
Arthroplast Today 2021 Oct;11:157-62. doi: 10.1016/j.artd.2021.08.010..
Keywords: Surgery, Orthopedics, Adverse Events, Risk
Long S, Thomas GW, Karam MD
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
This study introduces and evaluates a novel Image-based Decision Error Analysis (IDEA) score that captures performance during fluoroscopically assisted wire navigation. Findings showed that the fluoroscopic images obtained in the course of placing a guide wire contained a rich amount of information related to surgical skill. The IDEA scoring provided a basis for evaluating the competence of a resident. The score can be used to assess skill at key timepoints throughout residency, such as when rotating onto/off of a new surgical service and before performing certain procedures in the operating room, or as a tool for debriefing/providing feedback after a procedure is completed.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Karam MD .
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
Clin Orthop Relat Res 2021 Jun;479(6):1386-94. doi: 10.1097/corr.0000000000001623..
Keywords: Orthopedics, Surgery, Shared Decision Making, Medical Errors, Adverse Events, Imaging
Schwarzkopf R, Behery OA, Yu H
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
Unplanned readmissions following elective total hip (THA) and knee (TKA) arthroplasty as a result of surgical complications likely have different quality improvement targets and cost implications than those for nonsurgical readmissions. In this study, the investigators compared payments, timing, and location of unplanned readmissions with Center for Medicare and Medicaid Services (CMS)-defined surgical complications to readmissions without such complications.
AHRQ-funded; HS022882.
Citation: Schwarzkopf R, Behery OA, Yu H .
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
J Arthroplasty 2019 Oct;34(10):2304-07. doi: 10.1016/j.arth.2019.05.046..
Keywords: Orthopedics, Surgery, Hospital Readmissions, Adverse Events, Quality Improvement, Quality of Care, Medicare, Hospitals
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Lewis SS, Dicks KV, Chen LF
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The researchers compared time to diagnosis of invasive surgical site infection (SSI) following hip vs knee arthroplasty. They found that time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume. They hypothesized that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis.
AHRQ-funded; HS023866.
Citation: Lewis SS, Dicks KV, Chen LF .
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
Clin Infect Dis 2015 Apr 1;60(7):990-6. doi: 10.1093/cid/ciu975.
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Keywords: Diagnostic Safety and Quality, Healthcare-Associated Infections (HAIs), Orthopedics, Surgery, Injuries and Wounds, Adverse Events