National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Blood Clots (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Education: Continuing Medical Education (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
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- Health Information Technology (HIT) (2)
- Health Status (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (3)
- Injuries and Wounds (2)
- Kidney Disease and Health (1)
- Obesity (1)
- Orthopedics (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
- Patient Safety (6)
- Quality Improvement (1)
- Respiratory Conditions (1)
- (-) Risk (16)
- Shared Decision Making (1)
- (-) Surgery (16)
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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 16 of 16 Research Studies DisplayedVogel TR, Smith JB, Kruse RL
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
This retrospective cohort study evaluated factors associated with all-cause 30-day readmission after lower extremity amputation procedures. The investigators asserted that the finding- that acute arterial embolism or thrombosis and a below the knee amputation during the index admission was highly associated with readmission, combined with the high rates of 30-day conversion to an above the knee amputation when readmitted- suggests these patients more often develop stump complications or may be undertreated during the initial hospitalization.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
PM R 2018 Dec;10(12):1321-29. doi: 10.1016/j.pmrj.2018.05.017..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Risk, Surgery
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs
Leeds IL, Rosenblum AJ, Wise PE
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
This study examined barriers to surgical trainees in using risk calculator tools before surgery. A total of 124 surgical residents responded to a survey and most still favored more traditional methods for risk calculation including direct verbal communication, sketch diagrams, and brochures. Only about half or less were familiar with more contemporary tools such as best-worst case scenario framing, case-specific risk calculators, and all-procedure calculators.
AHRQ-funded; HS024736.
Citation: Leeds IL, Rosenblum AJ, Wise PE .
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
Surgery 2018 Nov;164(5):1117-23. doi: 10.1016/j.surg.2018.07.002..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Education: Continuing Medical Education, Risk, Surgery
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Dworsky JQ, Childers CP, Maggard-Gibbons M
High-risk colorectal surgery: what are the outcomes for geriatric patients?
This study examines the national burden and age-specific outcomes of previously defined high-risk colorectal procedures (HRCP) in geriatric patients using the 2014 National Inpatient Sample. The authors found that outcomes after HRCP are worse for older patients and for nonelective cases. They suggest that this information can inform preoperative counseling and targeted quality improvement projects.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Childers CP, Maggard-Gibbons M .
High-risk colorectal surgery: what are the outcomes for geriatric patients?
Am Surg 2018 Oct;84(10):1650-54..
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Outcomes, Risk, Surgery
Wahl TS, Graham LA, Morris MS
Association between preoperative proteinuria and postoperative acute kidney injury and readmission.
This retrospective cohort study investigated whether preoperative proteinuria is associated with surgical outcomes including postoperative acute kidney injury (AKI) and readmission. The cohort used were undergoing elective inpatient surgery at 119 Veterans Affairs facilities from October 2007 to September 2014. The data collected was for a 7-month period in 2016. A higher probability of 30-day unplanned readmission was associated with preoperative proteinuria and postoperative AKI.
AHRQ-funded; HS013852.
Citation: Wahl TS, Graham LA, Morris MS .
Association between preoperative proteinuria and postoperative acute kidney injury and readmission.
JAMA Surg 2018 Sep;153(9):e182009. doi: 10.1001/jamasurg.2018.2009..
Keywords: Kidney Disease and Health, Injuries and Wounds, Adverse Events, Surgery, Risk, Hospital Readmissions, Outcomes
Grundmeier RW, Xiao R, Ross RK
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
The objective of this study was to prospectively derive and validate a prediction rule for detecting cases warranting investigation for surgical site infections (SSI) after ambulatory surgery. The investigators concluded that electronic health record data can facilitate SSI surveillance with adequate sensitivity and positive predictive value.
AHRQ-funded; HS020921.
Citation: Grundmeier RW, Xiao R, Ross RK .
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
J Am Med Inform Assoc 2018 Sep;25(9):1160-66. doi: 10.1093/jamia/ocy075..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk, Patient Safety, Adverse Events, Ambulatory Care and Surgery
Garcia AV, Ladd MR, Crawford T
Analysis of risk factors for morbidity in children undergoing the Kasai procedure for biliary atresia.
The purpose of the study was to evaluate the perioperative risk factors for 30-day complications of the Kasai procedure in a large, cross-institutional, modern dataset. The authors concluded that major cardiac risk factors and perioperative blood transfusions increased the risk of post-operative complications in children undergoing the Kasai procedure. They assert that further research is warranted in the perioperative use of blood transfusions in this population.
AHRQ-funded; HS022932.
Citation: Garcia AV, Ladd MR, Crawford T .
Analysis of risk factors for morbidity in children undergoing the Kasai procedure for biliary atresia.
Pediatr Surg Int 2018 Aug;34(8):837-44. doi: 10.1007/s00383-018-4298-1.
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Keywords: Children/Adolescents, Outcomes, Risk, Surgery
Lambert-Kerzner A, Ford KL, Hammermeister KE
Assessment of attitudes towards future implementation of the "Surgical Risk Preoperative Assessment System" (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators.
Implementation of the Surgical Risk Preoperative Assessment System (SURPAS), an innovative real time, universal, preoperative tool providing individualized risk assessment, may enhance informed consent and reduce adverse outcomes. To ensure optimal development and implementation of SURPAS the study authors performed an in-depth pre-implementation evaluation of SURPAS at an academic tertiary referral center in Colorado.
AHRQ-funded; HS024124.
Citation: Lambert-Kerzner A, Ford KL, Hammermeister KE .
Assessment of attitudes towards future implementation of the "Surgical Risk Preoperative Assessment System" (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators.
Patient Saf Surg 2018 Jun 4;12:12. doi: 10.1186/s13037-018-0159-z..
Keywords: Health Information Technology (HIT), Quality Improvement, Risk, Surgery, Tools & Toolkits
Vogel TR, Smith JB, Kruse RL
Hospital readmissions after elective lower extremity vascular procedures.
This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Factors associated with readmission following lower extremity bypass included heart failure, transfusions, hyponatremia, black race, and bronchodilator use. Risk factors for endovascular readmissions were often chronic conditions including coronary artery disease, kidney disease, hypertension, and hypertensive medications.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Hospital readmissions after elective lower extremity vascular procedures.
Vascular 2018 Jun;26(3):250-61. doi: 10.1177/1708538117728637.
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Keywords: Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk, Surgery
Skube SJ, Lindemann EA, Arsoniadis EG
Characterizing functional health status of surgical patients in clinical notes.
The researchers of this study hypothesize that important functional status data is contained in clinical notes. They found that several categories of phrases related to functional status including diagnoses, activity and care assessments, physical exam, functional scores, assistive equipment, symptoms, and surgical history were important factors. They conducted a chart review and compared functional health status level terms from the chart review to National Surgical Quality Improvement Program determinations.
AHRQ-funded; HS024532.
Citation: Skube SJ, Lindemann EA, Arsoniadis EG .
Characterizing functional health status of surgical patients in clinical notes.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2017:379-88..
Keywords: Health Status, Patient Safety, Risk, Surgery, Electronic Health Records (EHRs)
Roberto SA, Bayes J, Karner PE
Patient harm in cataract surgery: a series of adverse events in Massachusetts.
This study examined the reported adverse events (AEs) involving cataract surgery in Massachusetts from 2011 to 2015. There were 37 AEs reported, with 15 anesthesia related, 5 were wrong eye blocks, 3 cases of hemodynamic instability, 2 retrobulbar hematoma/hemorrhages, and 5 globe perforations resulting in permanent loss of vision. However, the authors believe the numbers reported to Massachusetts state agencies are lower than the true number of AEs.
AHRQ-funded; HS024764.
Citation: Roberto SA, Bayes J, Karner PE .
Patient harm in cataract surgery: a series of adverse events in Massachusetts.
Anesth Analg 2018 May;126(5):1548-50. doi: 10.1213/ane.0000000000002526..
Keywords: Adverse Events, Eye Disease and Health, Patient Safety, Risk, Surgery
Bateni SB, Bold RJ, Meyers FJ
Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery.
Since preoperative risk stratification is critical, researchers sought to compare three standard risk indices, the American Society of Anesthesiology (ASA) classification, Charlson comorbidity index (CCI), and modified frailty index (mFI). Serious morbidity and mortality rates were 20.4 percent and 14.8 percent. ASA and CCI did not predict serious morbidity or prolonged length of stay, but were predictors of mortality.
AHRQ-funded; HS022236.
Citation: Bateni SB, Bold RJ, Meyers FJ .
Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery.
J Surg Oncol 2018 Mar;117(3):479-87. doi: 10.1002/jso.24866.
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Keywords: Adverse Events, Cancer, Patient Safety, Risk, Surgery
Goto T, Tsugawa Y, Faridi MK
Reduced risk of acute exacerbation of COPD after bariatric surgery: a self-controlled case series study.
Little is known about the impact of weight reduction on chronic obstructive pulmonary disease (COPD)-related outcomes in patients who are obese. This study found that the risk of an ED visit or hospitalization for acute exacerbation of COPD substantially decreased after bariatric surgery in patients who are obese. This observation suggests the effectiveness of substantial weight reduction on COPD morbidity.
AHRQ-funded; HS023305.
Citation: Goto T, Tsugawa Y, Faridi MK .
Reduced risk of acute exacerbation of COPD after bariatric surgery: a self-controlled case series study.
Chest 2018 Mar;153(3):611-17. doi: 10.1016/j.chest.2017.07.003.
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Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Obesity, Risk, Surgery
Punglia RS, Jiang W, Lipsitz SR
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
In this article, the investigators developed a score to provide individualized information about ipsilateral breast tumor recurrence risk to guide treatment decisions. The authors indicate that their simple, no-cost risk score may be used by patients and physicians to facilitate preference-based decision-making about ductal carcinoma in situ management informed by a more accurate understanding of risks.
AHRQ-funded; 29020050016I.
Citation: Punglia RS, Jiang W, Lipsitz SR .
Clinical risk score to predict likelihood of recurrence after ductal carcinoma in situ treated with breast-conserving surgery.
Breast Cancer Res Treat 2018 Feb;167(3):751-59. doi: 10.1007/s10549-017-4553-5..
Keywords: Cancer: Breast Cancer, Risk, Surgery, Patient-Centered Outcomes Research
Cramer JD, Dilger AE, Schneider A
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
Researchers examined the rate of venous thromboembolism (VTE) for various otolaryngology procedures compared with an established average-risk field and low-risk field. They identified a high-risk group for VTE in otolaryngology; however, they found that most patients undergoing otolaryngology procedures are at low risk of VTE, indicating that guidelines for a low-risk population could be adapted to otolaryngology. The authors concluded that patients undergoing high-risk otolaryngology procedures should be considered as candidates for more aggressive VTE prophylaxis.
AHRQ-funded; HS023011.
Citation: Cramer JD, Dilger AE, Schneider A .
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
JAMA Otolaryngol Head Neck Surg 2018 Jan;144(1):9-17. doi: 10.1001/jamaoto.2017.1768..
Keywords: Surgery, Blood Clots, Risk, Adverse Events, Patient Safety