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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedMiano TA, Hennessy S, Yang W
Association of vancomycin plus piperacillin-tazobactam with early changes in creatinine versus cystatin C in critically ill adults: a prospective cohort study.
The purpose of this study was to test the hypothesis that the association between vancomycin + piperacillin-tazobactam and increased acute kidney injury (AKI) risk by contrasting changes in creatinine concentration after antibiotic initiation with changes in cystatin C concentration. The researchers included patients enrolled in the Molecular Epidemiology of SepsiS in the ICU (MESSI) prospective cohort who were treated for greater than or equal to 48 h with vancomycin + piperacillin-tazobactam or vancomycin + cefepime. The kidney function biomarkers of blood urea nitrogen (BUN), creatinine, and cystatin C were measured before antibiotic treatment and again on day two after initiation. Creatinine-defined AKI and dialysis were evaluated through day14, and mortality was assessed through day 30. The study found that in the 739 patients vancomycin + piperacillin-tazobactam was associated with a higher percentage increase of creatinine at day-two and a higher incidence of creatinine-defined AKI: rate ratio. Vancomycin + piperacillin-tazobactam was not associated with change in alternative biomarkers. The researchers concluded that the study supports the hypothesis that vancomycin + piperacillin-tazobactam effects on creatinine represent pseudotoxicity.
AHRQ-funded; HS027626.
Citation: Miano TA, Hennessy S, Yang W .
Association of vancomycin plus piperacillin-tazobactam with early changes in creatinine versus cystatin C in critically ill adults: a prospective cohort study.
Intensive Care Med 2022 Sep;48(9):1144-55. doi: 10.1007/s00134-022-06811-0..
Keywords: Critical Care, Medication, Kidney Disease and Health, Adverse Drug Events (ADE), Adverse Events
Cheetham MS, Zhao J, McCullough K
International peritoneal dialysis training practices and the risk of peritonitis.
In peritoneal dialysis (PD), the impact of training on patient outcomes is not well understood, with a lack of evidence to inform best practices in training. The purpose of this study was to compare international PD training practices and evaluate their association with peritonitis. In this prospective study, a cohort of 1,376 adult patients from 120 facilities across 7 counties were included, all of whom were participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) and were on PD for greater than 3 months. Training characteristics were reported at patient and facility levels and included duration, location, and modality of training, use of individual/ group training, use of written/ oral competency assessments, training of family members, and nurse affiliation. The study found that training was most typically conducted in a one-on-one setting (79%) by facility-affiliated nurses (87%) at the facility (81%). In 5 of 14 United Kingdom facilities, receiving training from both facility and external, third-party nurses was associated with a reduced risk of peritonitis. However, no other training characteristics were significantly associated with risk of peritonitis. The study concluded that in this study, there was no evidence that risk of peritonitis was associate with the assessed characteristics of PD patient training.
AHRQ-funded; HS025756.
Citation: Cheetham MS, Zhao J, McCullough K .
International peritoneal dialysis training practices and the risk of peritonitis.
Nephrol Dial Transplant 2022 Apr 25;37(5):937-49. doi: 10.1093/ndt/gfab298..
Keywords: Kidney Disease and Health, Adverse Events, Training
Zhang J, Drawz PE, Zhu Y
Validation of administrative coding and clinical notes for hospital-acquired acute kidney injury in adults.
This retrospective study validated the quality of administrative coding for hospital-acquired acute kidney injury (AKI) and explored the opportunities to improve the phenotyping performance by utilizing additional data sources from the electronic health record. The researchers obtained significantly different quality measures of administrative coding from the previously reported ones in the U.S. They recommended the additional use of clinical notes by incorporating automatic natural language processing data extraction in order to increase the AUC in phenotyping AKI. Further, AKI was better recognized in patients with heart failure, indicating disparities in the coding and management of AKI.
AHRQ-funded; HS024532.
Citation: Zhang J, Drawz PE, Zhu Y .
Validation of administrative coding and clinical notes for hospital-acquired acute kidney injury in adults.
AMIA Annu Symp Proc 2022 Feb 21;2021:1234-43..
Keywords: Adverse Events, Kidney Disease and Health, Health Information Technology (HIT), Hospitals