National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Brain Injury (4)
- Care Management (1)
- Children/Adolescents (2)
- Critical Care (1)
- Evidence-Based Practice (1)
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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 4 of 4 Research Studies DisplayedLuther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Piantino JA, Lin A, Crowder D
Early heart rate variability and electroencephalographic abnormalities in acutely brain-injured children who progress to brain death.
This study retrospective case-control study explored the hypothesis that lower heart rate variability in brain-injured children is an early indicator of autonomic system failure and predicts progression to brain death. The association between heart rate variability and markers of brain dysfunction between brain-injured children who progressed to brain death and those who survived is also examined. Heart rate variability in patients was estimated using 5-minute electrocardiogram segments. Patients who progressed to brain death exhibited significantly lower heart rate variability in the time and frequency domains. Heart rate variability was significantly lower in those patients with discontinuous or attenuated/featureless electroencephalogram than those with slow/disorganized background. The researchers conclude that these findings support the concept of autonomic system failure as an early indicator of impending brain death, and that decreased heart rate variability is associated with markers of central nervous system dysfunction, such as electroencephalogram abnormalities.
AHRQ-funded; HS022981.
Citation: Piantino JA, Lin A, Crowder D .
Early heart rate variability and electroencephalographic abnormalities in acutely brain-injured children who progress to brain death.
Pediatr Crit Care Med 2019 Jan;20(1):38-46. doi: 10.1097/pcc.0000000000001759..
Keywords: Brain Injury, Children/Adolescents, Neurological Disorders, Outcomes
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Bush RA, Beaumont JL, Liotta EM
Fever burden and health-related quality of life after intracerebral hemorrhage.
In this prospective observational cohort study, the investigators tested the hypothesis that increased burden of fever is independently associated with decreased health-related quality of life (HRQoL) at follow-up. The authors found that each additional day with a fever was predictive of worse HRQoL domains of Cognitive Function and Mobility after intracerebral hemorrhage up to 1 year. They suggest that HRQoL outcomes may be a sensitive and powerful way to measure the efficacy of fever control in future research.
AHRQ-funded; HS023437.
Citation: Bush RA, Beaumont JL, Liotta EM .
Fever burden and health-related quality of life after intracerebral hemorrhage.
Neurocrit Care 2018 Mar 29;29(2):189-94. doi: 10.1007/s12028-018-0523-y..
Keywords: Brain Injury, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Quality of Life