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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 4 of 4 Research Studies DisplayedAnesi GL, Liu VX, Chowdhury M
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
ICU capacity is strained and its capacity and effectiveness are limited because many patient admission decisions are not evidence-based regarding who benefits from admission triage. The purpose of the study was to measure the benefits of admission to the ICU in patients who were experiencing sepsis or acute respiratory failure. Researchers looked retrospectively from 2013 to 2018 at cohorts within 27 U.S. hospitals across two health systems. They compared ICU admission vs ward admission among patients with sepsis and/ or acute respiratory failure who did not require vasopressors or mechanical ventilation in the emergency department. Study results revealed in patients with sepsis that ICU admission was associated with a hospital stay of 1.32 days longer than ward admissions, with a higher in-hospital mortality ratio. In patients with respiratory failure, ICU admission was associated with a .82-day shorter length of stay and reduced in-patient mortality. Within the two groups, subgroup analysis was conducted, and results revealed that for patients with sepsis, harms were concentrated among older patients and patients with fewer comorbidities. In addition, for patients with respiratory failure, the benefits were concentrated among older patients, patients with higher lab-based acute physiology scores (“high acuity” patients), and patients with comorbidities. The study concluded that among sepsis patients with high acuity scores and not requiring life support in the emergency department, initial admission to the ward was associated with shorter length of stay and improved survival, compared to the same category of patients admitted to the ICU. This result differed from patients with acute respiratory failure, for whom triage to the ICU was associated with improved survival when compared to admission to the ward.
AHRQ-funded; HS026372.
Citation: Anesi GL, Liu VX, Chowdhury M .
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
Am J Respir Crit Care Med 2022 Mar 1;205(5):520-28. doi: 10.1164/rccm.202106-1350OC..
Keywords: Intensive Care Unit (ICU), Sepsis, Respiratory Conditions, Outcomes
Krutsinger DC, Yadav KN, Harhay MO
A systematic review and meta-analysis of enrollment into ARDS and sepsis trials published between 2009 and 2019 in major journals.
This systematic review and meta-analysis looked at enrollment rates for randomized controlled trials (RCTs) conducted in the ICU, with the focus on patients with acute respiratory distress syndrome (ARDS), acute lung injury (ALI), or sepsis, and which factors influenced enrollment rates. The authors conducted a systematic review using PubMed for ARD/ALI and sepsis to identify individually published RCTs among the seven highest impact general medicine and seven highest impact critical care journals between 2009 and 2019. A total of 457 articles were identified, with 94 trials meeting inclusion criteria. Trials most commonly evaluated were pharmaceutical interventions (53%), were non-industry funded (78%), and required prospective informed consent (81%). The overall enrollment rate was less than 1 participant per site per month, with single-center trials having a significantly higher enrollment rate than multicenter trials. Enrollment for sepsis trials was almost twice the rate as ARDS/ALI.
AHRQ-funded; HS027795.
Citation: Krutsinger DC, Yadav KN, Harhay MO .
A systematic review and meta-analysis of enrollment into ARDS and sepsis trials published between 2009 and 2019 in major journals.
Crit Care 2021 Nov 15;25(1):392. doi: 10.1186/s13054-021-03804-1..
Keywords: Sepsis, Respiratory Conditions
Anesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
Shappell CN, Klompas M, Rhee C
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Although some experts have unequivocally asserted that multiple organ failure arising from COVID-19 is sepsis, other case series of severe COVID-19 infections have not labeled the disease as sepsis despite the fact that patients have proven infection and organ dysfunction and therefore meet the formal definition of sepsis. In this study, the authors explore why this is the case, and whether or not it truly serves patients.
AHRQ-funded; HS025008.
Citation: Shappell CN, Klompas M, Rhee C .
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Crit Care Med 2020 Dec;48(12):1707-09. doi: 10.1097/ccm.0000000000004601..
Keywords: COVID-19, Sepsis, Respiratory Conditions