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Topics
- Adverse Drug Events (ADE) (1)
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- Critical Care (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 25 of 28 Research Studies DisplayedAnderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Saldanha IJ, Cao W, Bhuma MR
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
This article describes the systematic review paper that was done on management of primary headaches during pregnancy, postpartum, and breastfeeding, which won the 2021 American Headache Society’s Member’s Choice Award. The findings are summarized in this paper, which discusses different pharmacologic interventions and their possible effects on the fetus/child and mother. Evidence was summarized for prevention and treatment of primary headache. The authors did not find a lot of evidence for harms or benefits but called for more studies to be done.
AHRQ-funded; 290201500002I.
Citation: Saldanha IJ, Cao W, Bhuma MR .
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
Headache 2022 Jul;62(7):774-76. doi: 10.1111/head.14332..
Keywords: Neurological Disorders, Pregnancy, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
Nelson KE, Chakravarti V, Diskin C
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
This study’s objective was to assess the performance of previously published high-intensity neurologic impairment (NI) diagnosis codes in identification of hospitalized children with clinical NI. This retrospective study of 500 randomly selected discharges in 2019 was conducted at a freestanding children’s hospital. Charts were reviewed for: 1) NI discharge diagnosis codes and 2) documentation of clinical NI (a neurologic diagnosis and indication of functional impairment like medical technology). Diagnosis codes identified clinically documented NI with 88.1% specificity, and 79.4% sensitivity; negative predictive value (NPV) was 96.7%, and positive predictive value (PPV) was 49%. Including children with milder functional impaired results in NPV of 95.7% and PPV of 77.5%. Restriction to children with more severe functional impairment increased NPV and decreased PPV. Misclassification was mostly due to inclusion of children without functional impairments.
AHRQ-funded; HS025138.
Citation: Nelson KE, Chakravarti V, Diskin C .
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
Acad Pediatr 2022 Jul;22(5):782-88. doi: 10.1016/j.acap.2021.07.014..
Keywords: Children/Adolescents, Neurological Disorders, Diagnostic Safety and Quality
Givan A, Downer B, Chou LN
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
This longitudinal study’s aim was to examine the association between cognitive impairment and low physical function over a 20-year follow-up period among Mexican Americans aged 65 and older. The final sample included 1545 community-dwelling Mexican Americans from the Hispanic Established Population for the Epidemiological Study of the Elderly, who scored moderate-high on Short Physical Performance Battery (SPPB) and were non-disabled at baseline (1993/94). The Mini Mental State Examination scale defines cognitive impairment as less than 21 points. General Estimating Equation was used to estimate the odds of having low physical function (defined with the SPPB at <7 points) over time as a function of cognitive impairment, adjusting for socio-demographics, self-reported medical conditions, body mass index, and depressive symptoms. Participants with cognitive impairment had increased odds of lower physical function over time compared to those without cognitive impairment.
AHRQ-funded; HS026133.
Citation: Givan A, Downer B, Chou LN .
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
Ann Epidemiol 2022 Jun;70:9-15. doi: 10.1016/j.annepidem.2022.03.006..
Keywords: Elderly, Racial and Ethnic Minorities, Neurological Disorders
Green RK, Shah MN, Clark LR
Comparing emergency department use among individuals with varying levels of cognitive impairment.
This study compared the frequency of emergency department (ED) use among a cohort of individuals with mild to well-defined cognitive impairment. This retrospective cohort study of English-speaking, community-dwelling individuals was conducted at four health system-based multidisciplinary clinics from 2014 to 2016. The authors obtained demographic and clinical data, including neuropsychological testing results, through chart review and linkage to electronic health record data. They characterized the frequency and quantity of ED use within one year (6 months before and after) of cognitive evaluation and compared ED use between the three groups using bivariate and multivariate approaches. Of the 779 eligible patients, 89 were diagnosed as cognitively intact, 372 as having mild cognitive impairment (MCI), and 318 as having Alzheimer’s Disease and related dementias (ADRD). The proportion of subjects with any annual ED use did not significantly increase with greater cognitive impairment. The average number of ED visits also did not increase significantly with patients with MCI or ADRD having an elevated but non-significant risk of an ED visit compared to cognitively intact individuals.
AHRQ-funded; HS024558.
Citation: Green RK, Shah MN, Clark LR .
Comparing emergency department use among individuals with varying levels of cognitive impairment.
BMC Geriatr 2022 May 2;22(1):382. doi: 10.1186/s12877-022-03093-5..
Keywords: Emergency Department, Neurological Disorders, Healthcare Utilization
Washington KT, Kukulka K, Govindarjan R
Engaging specialist palliative care in the management of amyotrophic lateral sclerosis: a patient-, family-, and provider-based approach.
Investigators sought to describe key stakeholders' perspectives on specialist palliative care and its integration into the management of amyotrophic lateral sclerosis (ALS). Individual interviews were conducted with 42 stakeholders; the interview transcriptions were analyzed using inductive thematic analysis techniques. The investigators found that stakeholders expressed limited or inaccurate understandings of palliative care's definition and purpose. Stakeholders generally supported the integration of specialist palliative care into ALS management and recognized the value of early integration of palliative services in both the community and the clinical setting.
AHRQ-funded; HS022140.
Citation: Washington KT, Kukulka K, Govindarjan R .
Engaging specialist palliative care in the management of amyotrophic lateral sclerosis: a patient-, family-, and provider-based approach.
J Palliat Care 2022 Apr;37(2):170-76. doi: 10.1177/0825859719895827..
Keywords: Palliative Care, Neurological Disorders
Rafferty MR, Held Bradford EC, Fritz S
Health promotion and wellness in neurologic physical therapy: strategies to advance practice.
The purpose of this special interest article was to provide consensus-driven strategies to address barriers to implementing health promotion and wellness (HPW)-related neurologic physical therapy (PT) practice. Four key strategies emerged, and recommendations included having clinicians practice to their full scope of HPW-related PT practice, including optimizing movement, including physical activity and fitness, and reinforcing the importance of healthy sleep, nutrition, stress, and smoking cessation.
AHRQ-funded; HS025077.
Citation: Rafferty MR, Held Bradford EC, Fritz S .
Health promotion and wellness in neurologic physical therapy: strategies to advance practice.
J Neurol Phys Ther 2022 Apr 1;46(2):103-17. doi: 10.1097/npt.0000000000000376..
Keywords: Health Promotion, Neurological Disorders
Hua CL, Thomas KS, Bunker JN
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
This retrospective cohort study examined the association between a dementia diagnosis listed on a hospital claim and patient outcomes among individuals with a Minimum Data Set (MDS) assessment. The cohort was comprised of hospitalized patients aged 66 years and older with advanced dementia noted on an MDS assessment completed within 120 days prior to their first hospitalization in 2017. Among 120,989 patients with advanced dementia and a nursing home stay, 90.6% had a dementia diagnosis on their hospital claims. Documentation of a dementia diagnosis was associated with lower use of intensive care unit or coronary care unit, use of invasive mechanical ventilation, and 30-day mortality. These patients also had a shorter hospital length of stay.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker JN .
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
J Am Geriatr Soc 2022 Mar;70(3):846-53. doi: 10.1111/jgs.17564..
Keywords: Dementia, Diagnostic Safety and Quality, Medicare, Hospitals, Neurological Disorders
Yadgir SR, Engstrom C, Jacobsohn GC
Machine learning-assisted screening for cognitive impairment in the emergency department.
Researchers developed and evaluated an automated screening tool to identify a subset of patients at high risk for cognitive impairment (CI). Using the Blessed Orientation Memory Concentration (BOMC) test, administered in the emergency department, they found that an algorithm based on electronic health record data can define a subset of patients at higher risk for CI. They recommended that incorporating such an algorithm into a screening workflow could allow screening efforts and resources to be focused where they have the most impact.
AHRQ-funded; HS024558.
Citation: Yadgir SR, Engstrom C, Jacobsohn GC .
Machine learning-assisted screening for cognitive impairment in the emergency department.
J Am Geriatr Soc 2022 Mar;70(3):831-37. doi: 10.1111/jgs.17491..
Keywords: Neurological Disorders, Screening, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly
Lee W, Gray SL, Zaslavsky O
Association between having a family member with dementia and perceptions of dementia preventability.
This study examined how having a family history of dementia and caregiving experience are associated with perceptions about and self-efficacy for dementia preventability. Participants were surveyed whether they had a family member with dementia, and if they need whether they served as a caregiver. Of 1,575 respondents, 71% had a family member with dementia, and of those 42% served as a caregiver. People with a family member with dementia were less likely to believe that dementia is preventable and had lower self-efficacy for dementia prevention. Survey participants who were also caregivers had an even lower perception about dementia preventability.
AHRQ-funded; HS022982.
Citation: Lee W, Gray SL, Zaslavsky O .
Association between having a family member with dementia and perceptions of dementia preventability.
Aging Ment Health 2022 Feb;26(2):270-76. doi: 10.1080/13607863.2020.1839866..
Keywords: Dementia, Caregiving, Family Health and History, Prevention, Neurological Disorders
Diskin C, Malik K, Gill PJ
Research priorities for children with neurological impairment and medical complexity in high-income countries.
This paper describes a modified three-stage Delphi study using online surveys to identify the highest-priority clinical research areas related to children with neurological impairment and medical complexity among clinicians and caregivers. Round 1 comprised of a diverse international expert panel of 49 clinicians and 12 family caregivers suggesting clinical topics and related questions that require research to support this subgroup of children. A steering committee refined the suggestions, and then participants contributed to 1 (family caregivers) or 2 (clinicians) subsequent rounds to develop a prioritized list. A total of 601 responses were provided, with the responses distilled into 26 clinical topics comprising 126 related questions. Top clinical topics prioritized for research were irritability and pain, child mental health, disorders of tone, polypharmacy, sleep, aspiration, behavior, dysautonomia, and feeding intolerance. Ten specific research questions were also prioritized by the clinician expert panel.
AHRQ-funded; HS025138.
Citation: Diskin C, Malik K, Gill PJ .
Research priorities for children with neurological impairment and medical complexity in high-income countries.
Dev Med Child Neurol 2022 Feb; 64(2):200-08. doi: 10.1111/dmcn.15037..
Keywords: Children/Adolescents, Neurological Disorders
Rosenthal M, Poling J, Wec A
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
This article investigated health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes and its companion coalitions. These programs were introduced in 2012 for the purpose of encouraging reductions in antipsychotic use and increasing use of nonpharmacological treatments for dementia. Interviews were conducted with 40 nursing home physicians and staff in seven states. The authors found that reducing antipsychotics is more time and resource-intensive than relying on medication. However, respondents supported reductions in antipsychotic use. They indicated that with supported staffing, effective communications, and training, they could create or implement individualized treatments.
AHRQ-funded; HS023464.
Citation: Rosenthal M, Poling J, Wec A .
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
J Appl Gerontol 2022 Jan;41(1):62-72. doi: 10.1177/0733464820958919..
Keywords: Elderly, Medication, Nursing Homes, Dementia, Neurological Disorders, Long-Term Care, Shared Decision Making
Kerber KA, Carender W, Telian SA
Patient self-management of benign paroxysmal positional vertigo: instructional video development and preliminary evaluation of behavioral outcomes.
Researchers sought to develop and preliminarily evaluate a patient-oriented benign paroxysmal positional vertigo of the posterior canal (PC-BPPV) self-management instructional video. They found that participants rated the PC-BPPV self-management video favorably on measures that contribute to behavioral intent to perform the Dix-Hallpike test or the canalith repositioning maneuver. These findings provide support that the video is appropriate to use in future studies that evaluate patient self-performance accuracy and outcomes.
AHRQ-funded; HS022258.
Citation: Kerber KA, Carender W, Telian SA .
Patient self-management of benign paroxysmal positional vertigo: instructional video development and preliminary evaluation of behavioral outcomes.
Otol Neurotol 2022 Jan;43(1):e105-e15. doi: 10.1097/mao.0000000000003360..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Neurological Disorders
Bayer ND, Hall M, LI Y
Trends in health care use and spending for young children with neurologic impairment.
This retrospective study examined trends in health care use and spending for young children with neurologic impairment (NI) during their first 5 years of life. This study of 13,947 children with NI used data in the multistate IBM Medicaid MarketScan Database from 2009 to 2017. Inpatient service use decreased from 66.8% during the first year down to 5.8% during the fifth year. Emergency department (ED) use decreased more gradually from 67.8% during the first year to 44.4% during the fifth year. Per-member-per-year spending decreased from $83,352 during the first year down to $1944 in the fifth year.
AHRQ-funded; HS025138.
Citation: Bayer ND, Hall M, LI Y .
Trends in health care use and spending for young children with neurologic impairment.
Pediatrics 2022 Jan;149(1). doi: 10.1542/peds.2021-050905.
AHRQ-funded; HS025138..
AHRQ-funded; HS025138..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Neurological Disorders
Siegler JE, Albright KC, George AJ
Time to neurological deterioration in ischemic stroke.
This study examined the time to neurological deterioration (ND) in ischemic stroke. The study concluded that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND.
AHRQ-funded; HS013852.
Citation: Siegler JE, Albright KC, George AJ .
Time to neurological deterioration in ischemic stroke.
Med Student Res J 2017 Winter;4:18-24. doi: 10.15404/msrj/03.2016.0005..
Keywords: Neurological Disorders, Outcomes, Stroke
Williams CN, Kirby A, Piantino J
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
To address morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals applied to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, the authors report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses.
AHRQ-funded; HS022981.
Citation: Williams CN, Kirby A, Piantino J .
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
Children 2017 Sep 19;4(9). doi: 10.3390/children4090083.
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Keywords: Brain Injury, Critical Care, Neurological Disorders, Patient-Centered Healthcare, Children/Adolescents
Ing C, Hegarty MK, Perkins JW
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
A study was done of children age 10 years who had volatile anaesthetic (VA) exposure sometime during their early childhood. Researchers were trying to determine if the duration of exposure affected long-term language and cognitive ability. Data was obtained from the Western Australian Pregnancy Cohort (Raine) Study. The cohort was divided by duration of total VA exposure before age three years. They concluded that children exposed to less than 35 minutes VA did not differ from unexposed children, but there were lower language scores in children who had experienced greater than 35 minutes.
AHRQ-funded; HS022941.
Citation: Ing C, Hegarty MK, Perkins JW .
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
Br J Anaesth 2017 Sep 1;119(3):532-40. doi: 10.1093/bja/aew413..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Neurological Disorders, Patient Safety
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention
Jorgensen SM, Carnahan RM, Weckmann MT
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. It concluded that the DOS appears to be an accurate way to screen for delirium in home hospice patients.
AHRQ-funded; HS022666.
Citation: Jorgensen SM, Carnahan RM, Weckmann MT .
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
Am J Hosp Palliat Care 2017 Sep;34(8):744-47. doi: 10.1177/1049909116658468.
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Keywords: Diagnostic Safety and Quality, Elderly, Home Healthcare, Neurological Disorders, Palliative Care
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kuntz KM, Dowd B .
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
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Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Krishnan S, York MK, Backus D
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
It is important for you to know if you have caregiver burnout, or the common triggers that may cause your burnout. By recognizing and addressing these factors, you will be able to take healthy and manageable control over your caregiver duties. The authors offer a number of specific recommendations to relieve caregiver stress and burden.
AHRQ-funded; HS022134.
Citation: Krishnan S, York MK, Backus D .
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
Arch Phys Med Rehabil 2017 Apr;98(4):805-07. doi: 10.1016/j.apmr.2016.11.002.
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Keywords: Caregiving, Neurological Disorders, Stress
Curtin CM, Kenney D, Suarez P
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release and trigger finger release. It found that oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms.
AHRQ-funded; HS024096.
Citation: Curtin CM, Kenney D, Suarez P .
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
J Hand Surg Am 2017 Mar;42(3):166-74. doi: 10.1016/j.jhsa.2016.12.011.
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Keywords: Neurological Disorders, Medication, Pain, Stress, Surgery
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Jutkowitz E, MacLehose RF, Gaugler JE
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
This study examined the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Sociodemographic characteristics and clinical comorbidities predicted cognitive and functional changes. Only cognitive status explained behavioral decline.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, MacLehose RF, Gaugler JE .
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
J Gerontol A Biol Sci Med Sci 2017 Feb;72(2):251-58. doi: 10.1093/gerona/glw079.
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Keywords: Dementia, Elderly, Behavioral Health, Neurological Disorders, Risk, Social Determinants of Health