Complications, Death More Likely Among Surgery Patients Transferred Between Hospitals

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Access more information on this topic in the associated Statistical Brief.

Today's Headlines:

• Complications, Death More Likely Among Surgery Patients Transferred Between Hospitals.
• Some Physicians Prioritize Unreliable Urinalysis Results When Treating Infections.
• Highlights From AHRQ’s Patient Safety Network.
• Register Now: June 30 Webinar on Challenge Competition for Improving Rural Postpartum Mental Health.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

Complications, Death More Likely Among Surgery Patients Transferred Between Hospitals

Patients transferred between hospitals to receive emergency general surgery are more likely to experience complications or death than patients directly admitted to a hospital, according to an AHRQ-funded study published in the journal Surgery. Patients with emergency general surgery conditions, such as appendicitis and small bowel obstruction, are a growing population, researchers noted. Using AHRQ’s Healthcare Cost and Utilization Project to analyze data on more than 10.7 million patient encounters, they found that nearly 40 percent of transferred patients experienced some complication, compared with over 25 percent of patients who were directly admitted. Over 4 percent of transferred patients died, compared with less than 2 percent of patients who were directly admitted. Researchers called for further study into the risk factors influencing higher death and complication numbers among transferred patients. Access the abstract.

Some Physicians Prioritize Unreliable Urinalysis Results When Treating Infections

Some physicians prescribing antibiotics for suspected urinary tract infections (UTIs) are basing their decisions primarily on urinalysis results, which are an unreliable basis for diagnosis, according to an AHRQ-funded study published in the Journal of the American Medical Directors’ Association. In surveys administered to 876 New Hampshire primary care physicians and advanced practice providers, researchers posed 19 different scenarios of patients with suspected UTIs and asked which patient characteristics would be most important when deciding whether to prescribe antibiotics. On average, they found that urinalysis results made up 32 percent of final prescribing decisions. That was higher than lower urinary tract symptoms (17 percent), body temperature (17 percent) and physical examinations (15 percent), each of which is recommended in guidelines for diagnosis. Access the abstract.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• National trends in the safety performance of electronic health record systems from 2009 to 2018.
• African American COVID-19 mortality: a sentinel event.
• Failure to follow medication changes made at hospital discharge is associated with adverse events in 30 days.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Register Now: June 30 Webinar on Challenge Competition for Improving Rural Postpartum Mental Health

A webinar on June 30 from 2 to 3:30 p.m. ET will provide an overview of AHRQ’s challenge competition to improve postpartum mental health care for rural American families. The presentation will include information about HHS’ ongoing efforts to address postpartum depression. The challenge seeks to elicit success stories and proposals to address postpartum mental health diagnoses and treatment in rural communities. Winners in the success story category will receive $15,000 each, and winners in the program proposal category can win up to $50,000 to support implementation. Submissions are due Sept. 15. Register for the webinar. 

New Research and Evidence From AHRQ

• Masks for Prevention of COVID-19 in Community and Healthcare Settings: A Living Rapid Review.
• ACTS COVID-19 Guidance-to-Action Collaborative.
• Systematic review (draft open for comment): Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes.

AHRQ in the Professional Literature

Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study. Gartlehner G, Wagner G, Lux L, et al. Syst Rev 2019 Nov 15;8(1):277. Access the abstract on PubMed®.

Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools. Gates A, Guitard S, Pillay J, et al. Syst Rev 2019 Nov 15;8(1):278. Access the abstract on PubMed®.

When rural hospitals close, the physician workforce goes. Germack HD, Kandrack R, Martsolf GR. Health Aff 2019 Dec;38(12):2086-94. Access the abstracton PubMed®.

Gaps in treatment and surveillance: head and neck cancer care in a safety-net hospital. Yu K, Westbrook M, Brodie S, et al. OTO Open 2020 Jan-Mar;4(1):2473974x19900761. Epub 2020 Feb 6. Access the abstract on PubMed®.

Patient outcomes following total joint replacement surgery: a comparison of hospitals and ambulatory surgery centers. Carey K, Morgan JR, Lin MY, et al. J Arthroplasty 2020 Jan;35(1):7-11. Epub 2019 Aug 23. Access the abstract on PubMed®.

Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes. Barry-Menkhaus SA, Wagner DV, Riley AR. Curr Diab Rep 2020 Jan 30;20(1):3. Access the abstract on PubMed®.

Reengineering skilled nursing facility discharge: analysis of reengineered discharge implementation. Popejoy LL, Wakefield BJ, Vogelsmeier AA, et al. J Nurs Care Qual 2020 Apr/Jun;35(2):158-64. Access the abstract on PubMed®.

Antipsychotics and the risk of mortality or cardiopulmonary arrest in hospitalized adults. Basciotta M, Zhou W, Ngo L, et al. J Am Geriatr Soc 2020 Mar;68(3):544-50. Epub 2019 Nov 19. Access the abstract on PubMed®.