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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
51 to 75 of 208 Research Studies DisplayedBrescia AA, Wu X, Paone G
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
Researchers explored whether there a sex-related difference on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. A prospective, observational study was conducted of 17,363 patients not on dialysis undergoing the procedure between 2011 and 2016 across 41 institutions from the Perfusion Measure and Outcomes registry. There was no sex-related differences found for nadir hematocrit or rates of acute kidney injury.
AHRQ-funded; HS026003; HS022535.
Citation: Brescia AA, Wu X, Paone G .
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
J Thorac Cardiovasc Surg 2019 Oct;158(4):1073-80.e4. doi: 10.1016/j.jtcvs.2019.03.042..
Keywords: Injuries and Wounds, Sex Factors, Kidney Disease and Health, Adverse Events, Surgery, Heart Disease and Health, Cardiovascular Conditions
Zhang T, Lary CW, Zullo AR
Post-hip fracture mortality in nursing home residents by obesity status.
This research letter discusses a study that examined whether obesity status affected mortality in post-hip fracture patients who were nursing home residents. A national cohort of nursing home (NH) residents was examined from national Medicare fee-for-service claims linked to the Minimum Data Set (MDS) from January 2008 through the end of 2009. A total of 33, 622 long-stay residents were identified who had been hospitalized for a hip fracture. They excluded 6918 patients due to a number of factors. They classified residents based on their BMI: normal BMI, overweight, mild obesity, or moderate/severe obesity. They found that being moderate/severely obese did not increase mortality.
AHRQ-funded; HS022998.
Citation: Zhang T, Lary CW, Zullo AR .
Post-hip fracture mortality in nursing home residents by obesity status.
J Am Geriatr Soc 2019 Sep;67(9):1983-85. doi: 10.1111/jgs.16028..
Keywords: Injuries and Wounds, Surgery, Nursing Homes, Obesity, Mortality, Elderly, Long-Term Care, Patient-Centered Outcomes Research
Libertucci J, Bassis CM, Cassone M
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
Researchers sought to determine if bacterial species colonizing open wounds are also found in the urine. Their pilot study of nursing home residents provided evidence that bacterial species identified within the urine can also be identified in open wounds in the same patient at one point in time. They recommended further studies to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of open wounds below the umbilicus.
AHRQ-funded; HS019767.
Citation: Libertucci J, Bassis CM, Cassone M .
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
mSphere 2019 Aug 28;4(4). doi: 10.1128/mSphere.00463-19..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety
Albrecht JS, Al Kibria GM, Greene CR
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
This study examined post-discharge mortality of older adults with traumatic brain injury (TBI) or non-TBI trauma compared with the general population. A retrospective cohort study of adults 65 years and older was conducted using data from an urban trauma center from 1997 to 2008. The data was then linked to the National Death Index through 2008 to obtain date and cause of death. A higher rate of death was associated with both cohorts after moderate to severe injury from accidents than for older adults without TBI or non-TBI trauma.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria GM, Greene CR .
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
J Am Geriatr Soc 2019 Jul 25;67(11):2382-86. doi: 10.1111/jgs.16098..
Keywords: Elderly, Hospital Discharge, Injuries and Wounds, Mortality, Trauma
Fink HA, MacDonald R, Forte ML
Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review.
Optimal long-term osteoporosis drug treatment (ODT) is uncertain. The purpose of this study was to summarize the effects of long-term ODT and ODT discontinuation and holidays. The investigators concluded that: long-term alendronate and zoledronic acid therapies reduce fracture risk in women with osteoporosis; long-term bisphosphonate treatment may increase risk for rare adverse events, and continuing treatment beyond 3 to 5 years may reduce risk for vertebral fractures; and long-term hormone therapy reduces hip fracture risks but has serious harms.
AHRQ-funded; 290201500008I.
Citation: Fink HA, MacDonald R, Forte ML .
Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review.
Ann Intern Med 2019 Jul 2;171(1):37-50. doi: 10.7326/m19-0533.
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Keywords: Evidence-Based Practice, Injuries and Wounds, Medication, Osteoporosis, Outcomes, Patient-Centered Outcomes Research, Prevention
Meagher AD, Lin A, Mandell SP
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Researchers conducted a retrospective cohort study to identify injured older adults at highest risk for 30-day mortality. They found that older, injured adults transported by EMS to a large variety of trauma and non-trauma hospitals were more likely to die within 30 days if they required emergent airway management or had a higher comorbidity burden. They concluded that identification of an ideal prognostic tool remains elusive.
AHRQ-funded; HS023796.
Citation: Meagher AD, Lin A, Mandell SP .
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Acad Emerg Med 2019 Jun;26(6):621-30. doi: 10.1111/acem.13727..
Keywords: Elderly, Trauma, Mortality, Injuries and Wounds, Emergency Department
Colla CH, Lewis VA, Stachowski C
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
In this study, researchers examined changes in more and less discretionary condition-specific postacute care use associated with Medicare accountable care organization (ACO) implementation. They found that ACOs decreased spending on postacute care by decreasing use of discretionary services. In addition, ACO implementation was associated with reduced length of stay in skilled nursing facilities, while hip fracture patients used institutional postacute settings at higher rates. The authors also observed decreases in spending, readmission days, and mortality among pneumonia patients.
AHRQ-funded; HS024698.
Citation: Colla CH, Lewis VA, Stachowski C .
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
Med Care 2019 Jun;57(6):444-52. doi: 10.1097/mlr.0000000000001121..
Keywords: Injuries and Wounds, Healthcare Costs, Healthcare Utilization, Hospitalization, Medicare, Pneumonia, Stroke
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation: Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial and Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Newgard CD, Lin A, Yanez ND
Long-term outcomes among injured older adults transported by emergency medical services.
This study examined the outcomes of injured older adults who were transported by emergency medical services (EMS) to the hospital. Older adults 65 years and older who were transported by 44 EMS agencies to 51 hospitals in 2011 were included and then had a 12-month follow-up through December 31, 2012. The majority of older adults were transported after a fall (84.5%). Serious injuries occurred in 3.5% with a serious extremity injury being the most common (17.8%). Mortality rates for older adults with severe injuries ranged from 1.6% in the hospital to 20.3% at 1 year. The most common causes of death was cardiovascular diseases and dementia.
AHRQ-funded; HS023796.
Citation: Newgard CD, Lin A, Yanez ND .
Long-term outcomes among injured older adults transported by emergency medical services.
Injury 2019 Jun;50(6):1175-85. doi: 10.1016/j.injury.2019.04.028..
Keywords: Elderly, Emergency Medical Services (EMS), Falls, Injuries and Wounds, Outcomes, Trauma
Randolph AC, Lin YL, Volpi E
Tricyclic antidepressant and/or gamma-aminobutyric acid-analog use is associated with fall risk in diabetic peripheral neuropathy.
This study invested whether tricyclic antidepressant and/or gamma-aminobutyric acid-analog (TCA/GABA) use is associated fall risk in older diabetic peripheral neuropathy (DPN) patients. A nationally representative 5% Medicare sample between the years 2008 and 2010 were used, and 5,550 patients with TCA/GABA prescriptions were compared to 22,200 patients without a TCA/GABA prescription. Patients were followed until there was an incidence of a fall or first incidence of a fracture during the follow-up period of up to 5 years. After covariate adjustment, there was a statistically significant increase in falls and fractures for patients using TCAs or GABA-analogs.
AHRQ-funded; HS020642.
Citation: Randolph AC, Lin YL, Volpi E .
Tricyclic antidepressant and/or gamma-aminobutyric acid-analog use is associated with fall risk in diabetic peripheral neuropathy.
J Am Geriatr Soc 2019 Jun;67(6):1174-81. doi: 10.1111/jgs.15779..
Keywords: Medication, Diabetes, Elderly, Falls, Injuries and Wounds, Medicare, Risk
Newgard CD, Lin A, Eckstrom E
Comorbidities, anticoagulants, and geriatric-specific physiology for the field triage of injured older adults.
In this study, the investigators evaluated the utility of comorbidities, anticoagulant use, and geriatric-specific physiologic measures to improve the sensitivity of the field triage guidelines for high-risk older adults in the out-of-hospital setting.
AHRQ-funded; HS023796.
Citation: Newgard CD, Lin A, Eckstrom E .
Comorbidities, anticoagulants, and geriatric-specific physiology for the field triage of injured older adults.
J Trauma Acute Care Surg 2019 May;86(5):829-37. doi: 10.1097/ta.0000000000002195
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Keywords: Elderly, Blood Thinners, Medication, Ambulatory Care and Surgery, Injuries and Wounds, Care Management
Gandek B, Roos EM, Franklin PD
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
The purpose of this study was to evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Results showed that KOOS-12 was a reliable and valid alternative to KOOS in total knee replacement patients with moderate to severe knee osteoarthritis and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
Osteoarthritis Cartilage 2019 May;27(5):762-70. doi: 10.1016/j.joca.2019.01.011..
Keywords: Arthritis, Evidence-Based Practice, Injuries and Wounds, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life
Galganski LA, Cox JA, Greenhalgh DG
Cervical spine injury in burned trauma patients: incidence, predictors, and outcomes.
This study examined incidence, predictors, and outcomes of burned trauma patients with cervical spine injuries (CIs). A retrospective cohort study of patients in the National Trauma Data Bank between 2007 and 2012 was conducted. There were a total of 94,964 patients in the study with 0.79% (745) patients with a diagnosis of CI. The most common mechanism for CI with a burn injury was motor vehicle injury, followed by falls, fire/flame, and explosion. Every year increase in patient age had a 1.05 higher odds of CI. Patients with CI had higher mortality, longer length of stay, intensive care unit length of day, and ventilator days.
AHRQ-funded; HS022236.
Citation: Galganski LA, Cox JA, Greenhalgh DG .
Cervical spine injury in burned trauma patients: incidence, predictors, and outcomes.
J Burn Care Res 2019 Apr 26;40(3):263-68. doi: 10.1093/jbcr/irz022..
Keywords: Trauma, Injuries and Wounds
Zullo AR, Zhang T, Lee Y
Effect of bisphosphonates on fracture outcomes among frail older adults.
The purpose of this study was to estimate the effects of bisphosphonates on hip fractures, nonvertebral fractures, and severe esophagitis among frail, older adults. Participants were residents of long-stay U.S. nursing homes who were 65 years and older and had no recent use of osteoporosis medication. The matched cohort included new bisphosphonate users and an equal number of calcitonin users. Outcomes for hip fracture, nonvertebral fracture, and esophagitis were measured using Part A claims. Bisphosphonate users were less likely than calcitonin users to experience hip fracture, but had similar rates of nonvertebral fracture and esophagitis events. The researchers conclude that bisphosphonate use is associated with a meaningful reduction in hip fracture among frail, older adults.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Lee Y .
Effect of bisphosphonates on fracture outcomes among frail older adults.
J Am Geriatr Soc 2019 Apr;67(4):768-76. doi: 10.1111/jgs.15725..
Keywords: Elderly, Injuries and Wounds, Medication, Outcomes, Patient-Centered Outcomes Research
Glass NE, Vadlamani A, Hwang F
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
The objectives of this study were to evaluate the incidence of bleeding, recurrent traumatic brain injury (TBI), and thromboembolic (TE) events after an initial TBI in older adults and to identify which factors contribute to this risk. The researchers found that, among Medicare patients hospitalized with TBI, the incidence of TE events was significantly higher than that of bleeding or recurrent TBI. They identified specific risk factors of bleeding and TE events, which may guide care of older adults after TBI.
AHRQ-funded; HS024560.
Citation: Glass NE, Vadlamani A, Hwang F .
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
J Surg Res 2019 Mar;235:615-20. doi: 10.1016/j.jss.2018.10.021..
Keywords: Brain Injury, Blood Clots, Elderly, Trauma, Injuries and Wounds, Risk, Adverse Events
Santosa KB, Keller M, Olsen MA
Negative-pressure wound therapy in infants and children: a population-based study.
Although the safety and benefits of negative-pressure wound therapy (NPWT) have been clearly demonstrated in the adult population, studies evaluating the safety and describing the use of NPWT in the pediatric population have been limited. In this study, the investigators performed a literature review and analyzed the Truven Health Analytics MarketScan Commercial Claims Databases from 2006 to 2014 to identify infants and children treated with NPWT.
AHRQ-funded; HS019455.
Citation: Santosa KB, Keller M, Olsen MA .
Negative-pressure wound therapy in infants and children: a population-based study.
J Surg Res 2019 Mar;235:560-68. doi: 10.1016/j.jss.2018.10.043..
Keywords: Children/Adolescents, Newborns/Infants, Pressure Ulcers, Injuries and Wounds, Care Management, Patient Safety
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Rhee C, Wang Jentzsch, MS
Comparison of hospital surgical site infection rates and rankings using claims versus National Healthcare Safety Network surveillance data.
This article examines national policies that target healthcare-associated infections by use of medical claims and National Healthcare Safety Network surveillance data. The authors looked at rates and rankings for surgical site infection following colon surgery in 155 hospitals, and found low concordance between these two data sources; they conclude that this underscores the limitations of evaluating hospital quality by using claims data.
AHRQ-funded; HS025008; HS000063; HS018414.
Citation: Rhee C, Wang Jentzsch, MS .
Comparison of hospital surgical site infection rates and rankings using claims versus National Healthcare Safety Network surveillance data.
Infect Control Hosp Epidemiol 2019 Feb;40(2):208-10. doi: 10.1017/ice.2018.310..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Surgery, Injuries and Wounds
Gerber JS, Ross RK, Szymczak JE
Infections after pediatric ambulatory surgery: incidence and risk factors.
Investigators studied the prevalence of surgical-site infections (SSIs) in a single pediatric healthcare network between ambulatory surgery facilities and a hospital-based facility. No statistical difference in the number of SSIs was found.
AHRQ-funded; HS020921.
Citation: Gerber JS, Ross RK, Szymczak JE .
Infections after pediatric ambulatory surgery: incidence and risk factors.
Infect Control Hosp Epidemiol 2019 Feb;40(2):150-57. doi: 10.1017/ice.2018.211..
Keywords: Ambulatory Care and Surgery, Children/Adolescents, Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Surgery, Injuries and Wounds
Myers SR, Branas CC, French B
A national analysis of pediatric trauma care utilization and outcomes in the United States.
The goal of this study was to provide the first national description of the proportion of injured children treated at pediatric trauma centers, and to clarify the presumed benefit of pediatric trauma center verification by comparing injury mortality across hospital types. The study used data from the 2006 Healthcare Cost and Utilization Project Kids Inpatient Database combined with national trauma center inventories. The results of the study may provide evidence that treatment of injured children at verified pediatric trauma centers may improve outcomes.
AHRQ-funded; HS017960; HS018604.
Citation: Myers SR, Branas CC, French B .
A national analysis of pediatric trauma care utilization and outcomes in the United States.
Pediatr Emerg Care 2019 Jan;35(1):1-7. doi: 10.1097/pec.0000000000000902..
Keywords: Children/Adolescents, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Trauma
Aspinall SL, Springer SP, Zhao X
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
This study investigated the association between taking central nervous system (CNS) medications with the risk of serious falls and hip fractures. Study participants were residents at a Veterans Health Administration (VHA) Community Living Center (CLC) between July 1, 2005 and June 30, 2009. This was a nested case-control study. The investigators concluded that there was a higher risk in those residents receiving 3.0 or more daily CNS medications.
AHRQ-funded; HS023779.
Citation: Aspinall SL, Springer SP, Zhao X .
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
J Am Geriatr Soc 2019 Jan;67(1):74-80. doi: 10.1111/jgs.15603..
Keywords: Elderly, Falls, Injuries and Wounds, Long-Term Care, Medication, Nursing Homes, Patient Safety, Risk
Albrecht JS, Al Kibria G, Gruber-Baldini A
Risk of mortality in individuals with hip fracture and traumatic brain injury.
Researchers estimated the prevalence of TBI (traumatic brain injury) with individuals hospitalized with hip fracture and their all-cause mortality. The population studied were Medicare beneficiaries aged 65 and older from 2006 to 2010. They concluded that there was a higher risk of death with individuals who had TBI than those who had only a hip fracture.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria G, Gruber-Baldini A .
Risk of mortality in individuals with hip fracture and traumatic brain injury.
J Am Geriatr Soc 2019 Jan;67(1):124-27. doi: 10.1111/jgs.15661..
Keywords: Brain Injury, Injuries and Wounds, Mortality, Risk, Trauma
Fan T, Duffy M
Screening for osteoporosis to prevent fractures.
This case study provides case questions and answers related to the U.S. Preventive Services Task Force recommendations on screening for osteoporosis to prevent fractures. It is part of the “Putting Prevention into Practice” series.
AHRQ-authored.
Citation: Fan T, Duffy M .
Screening for osteoporosis to prevent fractures.
Am Fam Physician 2018 Nov 15;98(10):593-94..
Keywords: Case Study, Injuries and Wounds, Osteoporosis, Prevention, Screening
McConeghy KW, Lee Y, Zullo AR
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
In this retrospective cohort study, the investigators evaluated the association between influenza and hip fracture hospitalizations in long-stay (LS) nursing home (NH) residents. The study authors found that influenza like illness (ILI) hospitalizations were associated with a 13% average increase in hip fracture hospitalization risk. In a given NH week, an increase in the number ILI hospitalizations from none to two was associated with an approximate one percentage point increase in hip fracture hospitalization risk.
AHRQ-funded; HS022998.
Citation: McConeghy KW, Lee Y, Zullo AR .
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
J Gerontol A Biol Sci Med Sci 2018 Nov 10;73(12):1638-42. doi: 10.1093/gerona/glx200..
Keywords: Elderly, Injuries and Wounds, Hospitalization, Influenza, Long-Term Care, Nursing Homes
Newgard CD, Malveau S, Zive D
Building a longitudinal cohort from 9-1-1 to 1-year using existing data sources, probabilistic linkage, and multiple imputation: a validation study.
The objective of this seven-county study was to describe and validate construction of a population-based, longitudinal cohort of injured older adults from 9-1-1 call to 1-year follow-up. Results showed that a population-based emergency care cohort with long-term outcomes can be constructed from existing data sources with high accuracy and reasonable validity of resulting variables.
AHRQ-funded; HS023796.
Citation: Newgard CD, Malveau S, Zive D .
Building a longitudinal cohort from 9-1-1 to 1-year using existing data sources, probabilistic linkage, and multiple imputation: a validation study.
Acad Emerg Med 2018 Nov;25(11):1268-83. doi: 10.1111/acem.13512..
Keywords: Data, Research Methodologies, Elderly, Emergency Department, Injuries and Wounds