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AHRQ Research Studies Date
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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 23 of 23 Research Studies DisplayedBartels K, Howard-Quijano K, Prin M
Meeting report: first Cardiovascular Outcomes Research in Perioperative Medicine conference.
This article summarized the background and objectives of the first Cardiovascular Outcomes Research in Perioperative Medicine (COR-PM) conference. It also described the conduct of the conference and outlined future directions for scientific meetings which are focused on the fostering of high-quality clinical research in the broader perioperative medicine community.
AHRQ-funded; HS027795.
Citation: Bartels K, Howard-Quijano K, Prin M .
Meeting report: first Cardiovascular Outcomes Research in Perioperative Medicine conference.
Anesth Analg 2023 Feb; 136(2):418-20. doi: 10.1213/ane.0000000000006248..
Keywords: Cardiovascular Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Rastogi V, Marcaccio CL, Kim NH
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
The purpose of this study was to assess perioperative outcomes in patients in the Vascular Quality Initiative who underwent juxta-/pararenal FEVAR with supraceliac vs infraceliac sealing. 1,486 Patients who received an elective FEVAR for juxta-/pararenal aortic aneurysms in the Vascular Quality Initiative between 2014 and 2021were identified and included.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
AHRQ-funded; HS027285.
Citation: Rastogi V, Marcaccio CL, Kim NH .
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
J Vasc Surg 2023 Jan;77(1):9-19.e2. doi: 10.1016/j.jvs.2022.08.007..
Keywords: Cardiovascular Conditions, Surgery, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Comparative Effectiveness, Treatments
Brown CS, Osborne NH, Kim GY
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
This study looked at outcomes for patients with varicose veins (C2 disease) undergoing truncal endovenous ablation with and without deep venous reflux. Data from the Vascular Quality Initiative was analyzed from 2015 to 2019. A total of 4881 patients were included, with 46.2% having combined deep and superficial reflux. Follow-up around a year later (median 336.5 days) was conducted after. Patients with deep reflux were less likely to be female, more likely to be Caucasian, and had no difference in BMI. Additionally, there were no differences in rates of prior varicose vein treatments, number of pregnancies, or history of deep venous thrombosis. However, patients without deep reflux were more likely to use anticoagulants at the time of the procedure. Patients without deep reflux had slightly higher median preprocedural Venous Clinician Severity Score (VCSS) scores as well as postprocedural VCSS scores. Total symptom score was higher for patients without deep reflux before and after the procedure, but there was no change in symptom score after the procedure. Patients with deep reflux had substantially higher rates of complications with a particular increase in proximal thrombus extension.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):361-68.e3. doi: 10.1016/j.jvsv.2020.04.031..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Brown CS, Obi AT, Cronenwett JL
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
This study looked outcomes of patients with varicose veins (C2 disease) who were treated with venous ablation alone or ablation plus phlebectomy using the Vascular Quality Initiative Varicose Vein Registry. Data between January 2015 and March 2015 was used to investigate postoperative as well as long-term clinical and patient-reported outcomes among patients with documented symptomatic C2 disease undergoing truncal endovenous ablations alone and combined ablation and phlebectomy. Out of 3375 patients, 40.1% underwent isolated truncal ablation and the rest had the combined procedure of ablation and phlebectomy. Complications were low for both procedures (8.4% and 8.7%). Overall, improvement in symptoms was experienced by 94.4% of patients with more increases in patients undergoing ablation and phlebectomy than ablation alone. Both procedures are recommended by the authors to be covered by insurance.
AHRQ-funded; HS000053.
Citation: Brown CS, Obi AT, Cronenwett JL .
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):369-76. doi: 10.1016/j.jvsv.2020.05.016..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Shared Decision Making
Brown CS, Osborne NH, Kim GY
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
This study compares outcomes in patients who have undergone unilateral vs bilateral venous ablation procedures or between staged and concurrent bilateral procedures. Data from the Vascular Quality Initiative from 2015 to 2019 was used to investigate immediate postoperative as well as long-term clinical and patient-reported outcomes. A total of 5029 patients were included, of whom 75.2% underwent unilateral procedures. Follow-up was conducted with a median of 227 days after. Unilateral patients were less likely to be female and white and had lower BMI compared with patients undergoing bilateral procedures. In addition, unilateral patients had fewer prior varicose vein treatments and had higher Venous Clinical Severity Scores (VCSS). There were no differences in complications in patients undergoing unilateral vs bilateral procedures. Systemic complications were rare in both groups.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Jan;9(1):113-21.e3. doi: 10.1016/j.jvsv.2020.05.008..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Bath J, Kruse RL, Smith JB
Association of postoperative glycemic control with outcomes after carotid procedures.
This study evaluated the relationship between suboptimal glucose control and adverse outcomes after carotid procedures. Patients admitted for elective carotid procedures from 2008-2015 were identified from the Cerner Healthfacts VR database using ICD-9-CM codes. Out of 4287 patients, 87% had optimal postoperative glucose control (80-180 mg/dL). Patients with suboptimal glucose control experienced higher stroke rates, more cardiac complications, longer hospital stays, higher rates of infection, and more complications overall than patients with optimal glucose control.
AHRQ-funded; HS022140.
Citation: Bath J, Kruse RL, Smith JB .
Association of postoperative glycemic control with outcomes after carotid procedures.
Vascular 2020 Feb;28(1):16-24. doi: 10.1177/1708538119866528..
Keywords: Adverse Events, Cardiovascular Conditions, Surgery, Patient-Centered Outcomes Research, Outcomes
Bath J, Smith JB, Kruse RL
Association of neutrophil-to-lymphocyte ratio with outcomes after elective abdominal aortic aneurysm repair.
This study investigated postoperative outcomes from elective abdominal aortic aneurysm surgery (AAA) repair using neutrophil-to-lymphocyte ratio as the predictor. Inpatients from the Cerner Health Facts database undergoing elective AAA repair from 2008 to 2015 were selected using ICD-9 procedure codes. Patients with a high postoperative NLR experienced longer hospital stays; higher rates of in-hospital death; high rates of renal failure, cardiac problems, respiratory problems, and infection compared to patients with a low postoperative NLR. The authors recommend future study of NLR to help provide clinically important risk profiles.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Association of neutrophil-to-lymphocyte ratio with outcomes after elective abdominal aortic aneurysm repair.
J Vasc Nurs 2019 Sep;37(3):213-20. doi: 10.1016/j.jvn.2019.06.001..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Hoch JM, Fatusin O, Yenokyan G
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
The purpose of this paper was to identify types of feeding methods following stage 2 palliation and their influence on length of stay. Results showed that feeding methods established at admission for stage 2 palliation are not likely to change by discharge, and that length of stay is more likely to be impacted by tube feeding and intubation history than by age or weight-for-age z score at admission. Recommendations included a better understanding for selection of feeding methods and their impact on patient outcomes in order to develop evidence-based guidelines to decrease variability in clinical practice patterns and to provide appropriate counseling to caregivers.
AHRQ-funded; HS021114.
Citation: Hoch JM, Fatusin O, Yenokyan G .
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
Congenit Heart Dis 2019 May;14(3):438-45. doi: 10.1111/chd.12742.
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Keywords: Nutrition, Newborns/Infants, Children/Adolescents, Hospitalization, Surgery, Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Tarbunou YA, Smith JB, Kruse RL
Outcomes associated with hyperglycemia after abdominal aortic aneurysm repair.
This study evaluated the association between postoperative hyperglycemia and outcomes after abdominal aortic aneurysm (AAA) repair. Once patients who underwent open or endovascular repair of a nonruptured AAA were identified, researchers evaluated the association between postoperative hyperglycemia and infections, in-hospital mortality, readmission, patients' characteristics, length of hospital stay, and medications. Multivariable logistic models were used examined the association of postoperative hyperglycemia with in-hospital infection and mortality. The results of the study show that patients who received endovascular repair and who had postoperative hyperglycemia had greater risk of infection and death. A diabetes diagnosis was associated with lower odds of both infection and in-hospital mortality, after controlling for insulin administration and postoperative hyperglycemia. The researchers conclude that hyperglycemia may be used as a clinical marker, since it was found to be significantly associated with inferior outcomes after elective AAA repair, but note that their study cannot imply causation.
AHRQ-funded; HS022140.
Citation: Tarbunou YA, Smith JB, Kruse RL .
Outcomes associated with hyperglycemia after abdominal aortic aneurysm repair.
J Vasc Surg 2019 Mar;69(3):763-73.e3. doi: 10.1016/j.jvs.2018.05.240..
Keywords: Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research, Surgery
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Chui PW, Parzynski CS, Ross JS
Association of statewide certificate of need regulations with percutaneous coronary intervention appropriateness and outcomes.
This study sought to characterize the association between state certificate of need (CON) regulations and percutaneous coronary interventions (PCI) appropriateness. The investigators found that states with CON had lower proportions of rarely appropriate PCI s, but the absolute differences were small. The investigators note that the findings suggest that CON regulations alone may not limit rarely appropriate PCI among patients with and without acute coronary syndrome.
AHRQ-funded; HS023000.
Citation: Chui PW, Parzynski CS, Ross JS .
Association of statewide certificate of need regulations with percutaneous coronary intervention appropriateness and outcomes.
J Am Heart Assoc 2019 Jan 22;8(2):e010373. doi: 10.1161/jaha.118.010373..
Keywords: Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research, Heart Disease and Health, Policy, Surgery
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research
Goldstone AB, Chiu P, Baiocchi M
Second arterial versus venous conduits for multi-vessel coronary artery bypass surgery in California.
This study sought to determine whether a second arterial conduit improves outcomes after multi-vessel coronary artery bypass grafting. It concluded that second arterial conduit use in California is low and declining, but arterial grafts were associated with significantly lower mortality and fewer cardiovascular events. A right internal thoracic artery graft offered no benefit over that of a radial artery, but did increase risk of sternal wound infection.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Second arterial versus venous conduits for multi-vessel coronary artery bypass surgery in California.
Circulation 2018 Apr 17;137(16):1698-707. doi: 10.1161/circulationaha.117.030959.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Mortality, Patient-Centered Outcomes Research, Surgery
Bachmann JM, Shah AS, Duncan MS
Cardiac rehabilitation and readmissions after heart transplantation.
Cardiac transplant recipients always are referred to cardiac rehabilitation (CR) after transplantation, and is associated with a lower 1-year readmission risk. This study’s objective was to determine rates of CR for heart transplant recipients in the US and also 1-year readmission rates using 2013-2014 Medicare data. Out of the 2,531 heart transplant patients in the US in 2013, about 24% received Medicare coverage and were included in the study. Rates of CR utilization was only, with only 55% participating in the program. Younger transplant patients ages 35 to 49 years were less likely to initiate CR than patients 65 and older. In all groups patients did not attend all 36 prescribed sessions, with a mean of 26.7 sessions attended. The 1-year readmission risk was 29% lower for CR participation patients.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Shah AS, Duncan MS .
Cardiac rehabilitation and readmissions after heart transplantation.
J Heart Lung Transplant 2018 Apr;37(4):467-76. doi: 10.1016/j.healun.2017.0.017.
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Keywords: Transplantation, Surgery, Rehabilitation, Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Bravo PE, Bergmark BA, Vita T
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. The aim of this study was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection.
AHRQ-funded; HS022998.
Citation: Bravo PE, Bergmark BA, Vita T .
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Eur Heart J 2018 Jan 21;39(4):316-23. doi: 10.1093/eurheartj/ehx683..
Keywords: Adverse Events, Cardiovascular Conditions, Diagnostic Safety and Quality, Evidence-Based Practice, Heart Disease and Health, Imaging, Patient-Centered Outcomes Research, Surgery
Goldstone AB, Chiu P, Baiocchi M
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
This study compared long-term mortality and rates of reoperation, stroke, and bleeding between cohorts of patients who underwent primary aortic-valve replacement or mitral-valve replacement with a mechanical or biologic prosthesis. The long-term mortality benefit associated with a mechanical prosthesis, as compared with a biologic prosthesis, persisted until 70 years of age among patients undergoing mitral-valve replacement and until 55 years of age among those undergoing aortic-valve replacement.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
N Engl J Med 2017 Nov 9;377(19):1847-57. doi: 10.1056/NEJMoa1613792.
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Keywords: Adverse Events, Cardiovascular Conditions, Medical Devices, Patient-Centered Outcomes Research, Surgery
Charles EJ, Johnston LE, Herbert MA
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. It concluded that Medicaid expansion was associated with fewer uninsured cardiac surgery patients and improved predicted risk scores and morbidity rates. In addition to improving health care financing, Medicaid expansion may positively affect patient care and outcomes.
AHRQ-funded; HS022535.
Citation: Charles EJ, Johnston LE, Herbert MA .
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
Ann Thorac Surg 2017 Oct;104(4):1251-58. doi: 10.1016/j.athoracsur.2017.03.079.
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Keywords: Patient-Centered Outcomes Research, Medicaid, Surgery, Cardiovascular Conditions, Policy
Holcomb CN, Hollis RH, Graham LA
Association of coronary stent indication with postoperative outcomes following noncardiac surgery.
The researchers sought to determine whether the clinical indication for a coronary stent is associated with postoperative major adverse cardiac events (MACE). They concluded that surgery in patients with a coronary stent placed for heart attack was associated with increased postoperative MACE rates compared with other stent indications.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Hollis RH, Graham LA .
Association of coronary stent indication with postoperative outcomes following noncardiac surgery.
JAMA Surg 2016 May;151(5):462-9. doi: 10.1001/jamasurg.2015.4545.
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Keywords: Surgery, Cardiovascular Conditions, Heart Disease and Health, Patient-Centered Outcomes Research
Murugiah K, Wang Y, Desai NR
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
The researchers studied hospital performance on transcatheter aortic valve replacement (TAVR) using data from all Medicare fee-for-service (FFS) beneficiaries 65 years of age and older who underwent TAVR from January 1, 2011, to December 31, 2013. They found that for an individual patient, the between-hospital variation translates to a great than 2-fold higher risk of dying within 30 days for a patient undergoing TAVR at a hospital 1 SD above the national average compared with undergoing TAVR at a hospital 1 SD below; the between-hospital variation was
AHRQ-funded; HS023000.
Citation: Murugiah K, Wang Y, Desai NR .
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
J Am Coll Cardiol 2015 Dec 15;66(23):2678-79. doi: 10.1016/j.jacc.2015.10.008.
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Keywords: Cardiovascular Conditions, Hospitals, Medicare, Patient-Centered Outcomes Research, Surgery
Fink HA, Hemmy LS, MacDonald R
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
This study summarized evidence about cognitive outcomes in adults aged 65 years or older at least 3 months after coronary or carotid revascularization, cardiac valve procedures, or ablation for atrial fibrillation. It concluded that intermediate- and long-term cognitive impairment in older adults attributable to the studied cardiovascular procedures may be uncommon.
AHRQ-funded; 2902007100641.
Citation: Fink HA, Hemmy LS, MacDonald R .
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
Ann Intern Med 2015 Jul 21;163(2):107-17. doi: 10.7326/m14-2793..
Keywords: Cardiovascular Conditions, Elderly, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Du DT, McKean SJ, Kelman JA, et al.
AHRQ Author: Encinosa W
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
The researchers compared early mortality after aortic valve replacement (AVR) between the recipients of mechanical and bioprosthetic aortic valves. Among 66,453 Medicare beneficiaries who received AVRs, use of mechanical valves was associated with a higher risk for death on the date of surgery and within 30 days compared with the bioprosthetic aortic valves. However, this applied only to those who underwent concurrent AVR and coronary artery bypass graft but not isolated AVR.
AHRQ-authored
Citation: Du DT, McKean SJ, Kelman JA, et al..
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
JAMA Intern Med. 2014 Nov;174(11):1788-95. doi: 10.1001/jamainternmed.2014.4300..
Keywords: Cardiovascular Conditions, Medicare, Mortality, Patient-Centered Outcomes Research, Surgery