National Healthcare Quality and Disparities Report
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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 72 Research Studies DisplayedIantorno SE, Scaife JH, Bryce JR
Emergency department utilization for pediatric gastrostomy tubes across the United States.
This study investigated the number and nature of emergency department (ED) visits to community hospitals for pediatric gastrostomy tube complication. The authors used the 2019 Nationwide Emergency Department Sample to perform a retrospective cross-sectional analysis of pediatric patients (<18 y) with a primary diagnosis of gastrostomy tube complication. Their primary outcome was a potentially preventable ED visit, defined as an encounter that did not result in any imaging, procedures, or an inpatient admission. They observed 32,036 ED visits at 535 hospitals and 15,165 (47.3%) were potentially preventable. Median age was 2 years, and 17,707 (55%) were male. Compared to White patients, patients with higher odds of potentially preventable visits were Black and Hispanic. Patients with residential zip codes in the first, second, and third median household income quartiles had higher odds of potentially preventable visits compared to the highest.
AHRQ-funded; HS025776.
Citation: Iantorno SE, Scaife JH, Bryce JR .
Emergency department utilization for pediatric gastrostomy tubes across the United States.
J Surg Res 2024 Mar; 295:820-26. doi: 10.1016/j.jss.2023.11.028.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Healthcare Utilization, Surgery, Adverse Events
Zondlak AN, Oh EJ, Neiman PU
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Individuals with intellectual disabilities may be at higher risk of delayed presentation and worse outcomes for emergency general surgery (EGS) conditions. The purpose of this study was to explore the relationship between intellectual disability and both severity of disease and clinical outcomes in patients presenting with typical EGS conditions. The study found that of 1,317,572 adult EGS admissions, 0.38% of patients had an ICD-9/-10 code consistent with current intellectual disability. EGS patients with intellectual disabilities had 31% greater odds of more severe disease at presentation when compared with neurotypical patients. Intellectual disability was also related with a higher likelihood of complications and mortality, longer lengths of stay, lower rate of discharge to home, and higher inpatient costs.
AHRQ-funded; HS028672; HS027788.
Citation: Zondlak AN, Oh EJ, Neiman PU .
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Ann Surg 2023 Nov 1; 278(5):e1118-e22. doi: 10.1097/sla.0000000000005863..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disabilities, Surgery, Outcomes
Murphy PB, Oslock WM, Ingraham AM
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
This study aimed to determine the influence of structure and process related to operating room access on achieving index cholecystectomy for gallstone pancreatitis. In 2015, 2811 US hospitals on acute care surgery practices were surveyed, including infrastructure for operative access, with 1690 hospitals (60%) responding. The authors identified patients ≥ 18 years who were admitted with gallstone pancreatitis. Over the study period, 5656 patients were admitted with gallstone pancreatitis, and 70% had an index cholecystectomy. High-performing hospitals had an index cholecystectomy rate of 84.1%, compared to 58.5% at low-performing hospitals. High-performing hospitals were associated with teaching, and access to dedicated daytime operative resources.
AHRQ-funded; HS022694.
Citation: Murphy PB, Oslock WM, Ingraham AM .
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
J Gastrointest Surg 2022 Apr;26(4):849-60. doi: 10.1007/s11605-021-05145-4..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Quality of Care
Greenberg JK, Brown DS, Olsen MA
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
This study's goal was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. The authors evaluated elective spinal surgeries performed in the U.S. from 2011 to 2016 and included 10 states with expanded Medicaid access and 4 states that did not. They identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% increase in mean hospital spine surgical volume and a 23% increase in Medicaid volume. Privately insured surgical volumes did not change significantly. This increase indicated improved access to care.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Brown DS, Olsen MA .
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
J Neurosurg Spine 2022 Feb;36(2):336–44. doi: 10.3171/2021.3.Spine2122..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Access to Care, Surgery
Ingraham A, Schumacher J, Fernandes-Taylor S
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
The authors sought to: (1) translate previously-developed ICD-9-CM diagnosis codes representing emergency general surgery (EGS) conditions to ICD-10-CM codes and (2) determine the national burden of and assess surgeon involvement across EGS conditions. They found that, of the seven most common EGS diagnoses, surgeon involvement was highest for appendicitis and biliary tract disease. For the other five most common conditions, surgeons were involved in roughly 20% of patient care episodes.
AHRQ-funded; HS025224.
Citation: Ingraham A, Schumacher J, Fernandes-Taylor S .
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
J Trauma Acute Care Surg 2022 Jan;92(1):117-25. doi: 10.1097/ta.0000000000003387..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Critical Care
Brauer DG, Wu N, Keller MR
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
This study investigates patient-level and hospital-level variables associated with the mortality difference at referral centers and, postoperatively, outside hospitals, in patients undergoing hepatopancreatobiliary (HPB) and gastric oncologic surgeries. Using HCUP data, findings showed that, for readmissions following HPB and gastric oncologic surgery, travel distance and timing were major determinants of care fragmentation. However, these variables were not associated with mortality, nor was annual hospital surgical volume after risk-adjustment.
AHRQ-funded; HS019455.
Citation: Brauer DG, Wu N, Keller MR .
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
J Am Coll Surg 2021 Jun;232(6):921-32. doi: 10.1016/j.jamcollsurg.2021.03.017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer, Surgery, Hospital Readmissions, Mortality
Langston DM, Oslock WM, Paredes AZ
Hospital location and socioeconomic disadvantage of emergency general surgery patients.
This study’s purpose was to test the hypothesis that a hospital’s neighborhood disadvantage is associated with vulnerability of its emergency general surgery (EGS) patients. An area deprivation index (ADI), which is a neighborhood-level measure of disadvantage, and key characteristics of 724 hospitals in 14 states were linked to patient-level data in State Inpatient Databases. Hospitals in more disadvantaged areas disproportionately serve underserved EGS patient populations but are less likely to have robust resources for EGS care or train future EGS surgeons.
AHRQ-funded; HS022694.
Citation: Langston DM, Oslock WM, Paredes AZ .
Hospital location and socioeconomic disadvantage of emergency general surgery patients.
J Surg Res 2021 May;261:376-84. doi: 10.1016/j.jss.2020.12.028..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Social Determinants of Health, Vulnerable Populations, Critical Care
Dy CJ, Salter A, Barker A
Increased utilization of total joint arthroplasty after Medicaid expansion.
This study examined prior analyses that greater utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) was to be expected after Medicaid expansion in 2014. Using 2012-2015 data from the HCUP Database, 9 expansion states (Arkansas, Arizona, Colorado, Iowa, Massachusetts, Maryland, Nevada, New York, and Vermont) were compared to 2 states that did not expand Medicaid (Florida and Missouri). After adjusting for community characteristics, THA and TKA increased 15% in 2014 and 23% in 2015 within expansion states compared to 2013. In non-expansion states, compared to 2013, there were significant decreases of 18% in 2014 and 11% in 2015.
AHRQ-funded; HS019455.
Citation: Dy CJ, Salter A, Barker A .
Increased utilization of total joint arthroplasty after Medicaid expansion.
J Bone Joint Surg Am 2021 Mar 17;103(6):524-31. doi: 10.2106/jbjs.20.00303..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Orthopedics, Surgery, Healthcare Utilization, Access to Care
Dworsky JQ, Shellito AD, Childers CP
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
Researchers investigated the prevalence and association of geriatric events (GEs) with clinical outcomes after elective surgery. Using National Inpatient Sample data, they found that, compared to admissions with no GEs, one or more GEs were associated with higher probability of worse outcomes including mortality, postoperative complications, prolonged length of stay, and discharge to a skilled nursing facility. They recommended efforts focusing on mutable factors responsible for GEs in order to optimize surgical care for older adults.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shellito AD, Childers CP .
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
J Surg Res 2021 Mar;259:192-99. doi: 10.1016/j.jss.2020.11.011..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Fernandes-Taylor S, Yang DY, Schumacher J
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
This study looked at the factors contributing to transfer of emergency general surgery (EGS) patients to another hospital. Data from the AHRQ Nationwide Emergency Department Sample (NEDS) from 2010-2014 was analyzed. The transfer rate during that time was 1.9%. Patients with Medicare or other insurance had higher odds of transfer compared to patients with private health insurance. Odds of transfer increased with a greater number of comorbid conditions as well as resuscitation, intestinal obstruction, and conditions of the upper gastrointestinal tract. Transfers were more likely to originate from rural hospitals or Level I or II trauma centers.
AHRQ-funded; HS025224.
Citation: Fernandes-Taylor S, Yang DY, Schumacher J .
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
Am J Emerg Med 2021 Feb;40:83-88. doi: 10.1016/j.ajem.2020.12.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Emergency Department, Transitions of Care, Hospitals, Healthcare Delivery
Diaz A, Ricci KB, Rushing AP
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
This study looked at factors linked to emergency surgery practices for small bowel obstruction (SBO) as opposed to non-operative treatment. Data from adult SBO patients from 17 Statewide Inpatient Databases (SIDS) was linked to the authors’ 2015 survey on emergency general surgery (EGS) practices including queries on operating room (OR) availability and surgical staffing. Of the 32,422 SBO patients identified, 83% were treated non-operatively. Operative patients tended to be older, had more comorbidities (53% vs. 46% with 3 or greater), and experienced more systemic complications (36% vs. 23%), higher mortality (2.8% vs. 1.4%), and longer length of stay (median 10 vs. 4 days). Patients had higher odds of operation if they were treated at hospitals with surgeons sometimes or rarely/never covering EGS at more than one location compared to always.
AHRQ-funded; HS022694.
Citation: Diaz A, Ricci KB, Rushing AP .
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
J Gastrointest Surg 2021 Feb;25(2):512-22. doi: 10.1007/s11605-019-04496-3..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Digestive Disease and Health
Yu J, Olsen MA, Margenthaler JA
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
In this study, the investigators examined the impact of patient and operative factors on 30-day hospital readmission following mastectomy for breast cancer. Using the 2011 HCUP California State Inpatient Database, they evaluated readmissions in adult women undergoing mastectomy for invasive, in situ, or history of breast cancer. The investigators found that surgical site infection and wound complications were the most common diagnoses requiring readmission and resulted in over half of readmissions in their study population at 30 days.
AHRQ-funded; HS19455.
Citation: Yu J, Olsen MA, Margenthaler JA .
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
Breast J 2020 Oct;26(10):1966-72. doi: 10.1111/tbj.14029..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Cancer: Breast Cancer, Cancer, Women
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
Oslock WM, Ricci KB, Ingraham AM
Role of interprofessional teams in emergency general surgery patient outcomes.
This paper discusses the results of a 2015 survey of acute care hospitals, which asked whether residents and advanced practice providers participate in emergency general surgery care. The data was then linked to patient data from 17 State Inpatient Databases using American Hospital Association identifiers to determine if that was associated with better management of patients, mortality, or complications. Eighty-three hospitals and 49,271 unique emergency general surgery admissions were included in the dataset. Hospitals with residents had reduced odds of systemic complications compared with hospitals without them or other clinical support. Hospitals with only residents had the lowest odds of operative complication.
AHRQ-funded; HS022694.
Citation: Oslock WM, Ricci KB, Ingraham AM .
Role of interprofessional teams in emergency general surgery patient outcomes.
Surgery 2020 Aug;168(2):347-53. doi: 10.1016/j.surg.2020.04.046..
Keywords: Healthcare Cost and Utilization Project (HCUP), Teams, Surgery, Adverse Events, Hospitals, Healthcare Delivery
Pollack LM, Olsen MA, Gehlert SJ
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
The objective of the study was to evaluate racial/ethnic variation in hysterectomy surgical route in women likely eligible for minimally invasive hysterectomy. The investigators concluded that African American, Hispanic, and Asian/PI women eligible for minimally invasive hysterectomy were more likely than White women to receive abdominal hysterectomy. In addition, the proportion of all women undergoing abdominal hysterectomy was highest at hospitals serving higher proportions of African American persons.
AHRQ-funded; HS019455; HS022330.
Citation: Pollack LM, Olsen MA, Gehlert SJ .
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
J Minim Invasive Gynecol 2020 Jul-Aug;27(5):1167-77. doi: 10.1016/j.jmig.2019.09.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Women, Surgery
Jiramongkolchai P, Lander DP, Kallogjeri D
Trend of surgery for orbital cellulitis: an analysis of state inpatient databases.
This study examined trends in surgery for orbital cellulitis from 2008 to 2015. Retrospective data was extracted from AHRQ’s State Inpatient Databases (SIDs) and patients with an ICD9-CM diagnosis code for orbital cellulitis were identified from Arkansas, Florida, Iowa, Maryland, Nebraska, New York and Wisconsin. The number of hospitalizations declined from a high of 1,574 down to 865 in 2014. The number of surgeries ranged from 103 to 154 from 2008 to 2015. For children, surgery was associated with age, ophthalmologic cormobidity, and conjunctival edema. For adults - male gender, private insurance, optic neuritis, and cranial nervs III/VI/VI palsy were associated with surgery.
AHRQ-funded; HS019455.
Citation: Jiramongkolchai P, Lander DP, Kallogjeri D .
Trend of surgery for orbital cellulitis: an analysis of state inpatient databases.
Laryngoscope 2020 Mar;130(3):567-74. doi: 10.1002/lary.28050..
Keywords: Healthcare Cost and Utilization Project (HCUP), Eye Disease and Health, Surgery, Hospitalization
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Strobel RJ, Likosky DS, Brescia AA
The effect of hospital market competition on the adoption of transcatheter aortic valve replacement.
The use of transcatheter aortic valve replacement (TAVR) has grown rapidly. The purpose of this study was to assess whether hospital market competition was associated with the use of TAVR. The investigators concluded that market competition was positively associated with a hospital's adoption of TAVR and indicated that future studies should further examine the impact of competition on quality and appropriateness.
AHRQ-funded; HS026003.
Citation: Strobel RJ, Likosky DS, Brescia AA .
The effect of hospital market competition on the adoption of transcatheter aortic valve replacement.
Ann Thorac Surg 2020 Feb;109(2):473-79. doi: 10.1016/j.athoracsur.2019.06.025..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Cardiovascular Conditions, Heart Disease and Health, Surgery
Ellis RJ, Schlick CJR, Yang AD
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
This paper discusses utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy (CRS/IPC) treatment for patients with peritoneal metastases (PM) in the United States. This treatment is becoming more popular in the US. The authors used the National Inpatient Sample to identify patients from 2006 to 2015 who underwent CRS/IPC. The number of CRS/IPC treatments increased from 189 to 1540. The most common indication was for appendiceal cancer, followed by ovarian and colorectal cancers. The procedure was performed the most in large teaching hospitals. The authors recommend the creation of a national registry dedicated to cases of IPC to help evaluate further use and outcomes.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Yang AD .
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
Ann Surg Oncol 2020 Jan;27(1):214-21. doi: 10.1245/s10434-019-07492-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Treatments, Cancer, Practice Patterns, Healthcare Utilization, Surgery
Strassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Shared Decision Making, Digestive Disease and Health
Subramanian MP, Liu J, Chapman WC
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
The objective of this study was to compare outcomes and hospitalization costs among patients undergoing open, video-assisted thoracoscopic surgery (VATS) and RATS lobectomy. The investigators concluded that minimally invasive approaches were associated to improved clinical outcomes compared with open lobectomy. However, only robotic-assisted lobectomy has had rapid growth in utilization. Despite additional cost, RATS lobectomy appeared to provide a viable minimally invasive alternative for general thoracic procedures.
AHRQ-funded; HS019455.
Citation: Subramanian MP, Liu J, Chapman WC .
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
Ann Thorac Surg 2019 Dec;108(6):1648-55. doi: 10.1016/j.athoracsur.2019.06.049..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Costs, Healthcare Utilization, Outcomes
Qi AC, Peacock K, Luke AA
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
The purpose of this study was to determine whether social risk factors, including race/ethnicity, insurance status, and neighborhood income, were associated with higher rates of surgical site infections (SSI) after colectomy or abdominal hysterectomy, 2 surgical procedures for which SSI rates are publicly reported and included in pay-for-performance programs by Medicare and other groups. The investigators report that inconsistent associations between social risk factors and SSIs were found.
AHRQ-funded; HS019455.
Citation: Qi AC, Peacock K, Luke AA .
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
JAMA Netw Open 2019 Oct 2;2(10):e1912339. doi: 10.1001/jamanetworkopen.2019.12339..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Social Determinants of Health
Dworsky JQ, Childers CP, Copeland T
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
This study analyzed the rate of geriatric events (GEs): delirium, dehydration, falls/fractures, failure to thrive, and pressure ulcers) with older adults undergoing nonelective surgery. The 2013 to 2014 National Inpatient Sample was used to analyze nonelective admissions for 5 common operations: laparoscopic cholecystectomy, colectomy, soft tissue debridgement, small bowel resection, and laparoscopic appendectomy in adults aged 65 years and older and a younger referent group (aged 55-65 years). Logistic regression estimated the association of age and outcomes with GEs. Having any GE was found to be associated with higher probability of all outcomes including mortality, postoperative complications, prolonged length of stay, and skilled nursing facility discharge.
AHRQ-funded; HS00046; HS025079.
Citation: Dworsky JQ, Childers CP, Copeland T .
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
Am Surg 2019 Oct;85(10):1089-93..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Ingraham A, Wang X, Havlena J
Factors associated with the interhospital transfer of emergency general surgery patients.
Researchers used data from the Nationwide Inpatient Sample to determine patient- and hospital-level factors associated with interhospital emergency general surgery (EGS) transfers. They identified that hospital-level characteristics more strongly predicted the need for transfer than patient-related factors. They recommended considering these factors in order to facilitate transfer decision-making.
AHRQ-funded; HS025224.
Citation: Ingraham A, Wang X, Havlena J .
Factors associated with the interhospital transfer of emergency general surgery patients.
J Surg Res 2019 Aug;240:191-200. doi: 10.1016/j.jss.2018.11.053..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Surgery, Shared Decision Making, Hospitals, Healthcare Delivery, Transitions of Care
Daniel VT, Rushing AP, Ingraham AM
Association between operating room access and mortality for life-threatening general surgery emergencies.
Few diseases truly require emergency surgery today. In this study, the authors investigated the relationship between access to operating room (OR) and outcomes for patients with life-threatening emergency general surgery (LT-EGS) diseases at US hospitals. The investigators concluded that round-the-clock availability of personnel, specifically emergency general surgeons and recovery room nurses, is associated with decreased mortality.
AHRQ-funded; HS022694.
Citation: Daniel VT, Rushing AP, Ingraham AM .
Association between operating room access and mortality for life-threatening general surgery emergencies.
J Trauma Acute Care Surg 2019 Jul;87(1):35-42. doi: 10.1097/ta.0000000000002267..
Keywords: Access to Care, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Surgery