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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
76 to 100 of 116 Research Studies DisplayedJules-Elysee KM, Goon AK, Westrich GH
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). It found that PAI did not decrease the time to discharge and was associated with higher pain scores and greater opioid consumption but lower ORSDS scores compared with PCEA.
AHRQ-funded; HS021734.
Citation: Jules-Elysee KM, Goon AK, Westrich GH .
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
J Bone Joint Surg Am 2015 May 20;97(10):789-98. doi: 10.2106/jbjs.n.00698..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Singh JA, Inacio MC, Namba RS
Rheumatoid arthritis is associated with higher ninety-day hospital readmission rates compared to osteoarthritis after hip or knee arthroplasty: a cohort study.
This study examined whether an underlying diagnosis of rheumatoid arthritis (RA) or osteoarthritis (OA) impacts the 90-day readmission rates after total hip arthroplasty (THA) or total knee arthroplasty (TKA). The 90-day post arthroplasty readmission risk after THA or TKA is higher in patients with rheumatoid arthritis (RA) compared to osteoarthritis.
AHRQ-funded; HS021110.
Citation: Singh JA, Inacio MC, Namba RS .
Rheumatoid arthritis is associated with higher ninety-day hospital readmission rates compared to osteoarthritis after hip or knee arthroplasty: a cohort study.
Arthritis Care Res 2015 May;67(5):718-24. doi: 10.1002/acr.22497..
Keywords: Arthritis, Hospital Readmissions, Arthritis, Surgery
Roxbury CR, Yang J, Salazar J
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
This study described safety and postoperative sequelae of pediatric otologic surgery and identify predictive factors for postoperative events. It found that pediatric otologic procedures are common and have low rates of global 30-day postoperative events. Tympanomastoidectomy and cochlear implantation have the highest risk of 30-day readmission.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Yang J, Salazar J .
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
Otolaryngol Head Neck Surg 2015 May;152(5):790-5. doi: 10.1177/0194599815575711..
Keywords: Adverse Events, Children/Adolescents, Surgery, Patient Safety, Children/Adolescents, Quality Improvement
Albrecht JS, Marcantonio ER, Roffey DM
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
This paper's objectives were to determine the stability of psychomotor subtypes of delirium over time and to identify characteristics associated with delirium psychomotor subtypes in individuals undergoing surgical repair of hip fracture. The Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair Cognitive Ancillary Study was conducted. Results showed that psychomotor subtypes of delirium often fluctuated from assessment to assessment, rather than representing fixed categories of delirium. Hypoactive delirium was the most common presentation of delirium but the least likely to be documented by healthcare providers.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Marcantonio ER, Roffey DM .
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
J Am Geriatr Soc 2015 May;63(5):970-6. doi: 10.1111/jgs.13334.
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Keywords: Adverse Events, Cardiovascular Conditions, Injuries and Wounds, Neurological Disorders, Surgery
Kumamaru H, Jalbert JJ, Nguyen LL
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
The objective of this study is to examine the decline in past-year case-volumes of surgeons performing carotid endarterectomy (CEA) before and after the National Coverage Determination (NCD) for carotid artery stenting (CAS) and to assess its effect on 30-day post-CEA mortality. It found that the rate of CEA procedures decreased substantially during 2001 to 2008. The postprocedural mortality in Medicare beneficiaries was high compared with trial patients.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
Stroke 2015 May;46(5):1288-94. doi: 10.1161/strokeaha.114.006276..
Keywords: Surgery, Mortality, Patient-Centered Outcomes Research, Outcomes, Elderly
Ayers DC, Fehring TK, Odum SM
Using joint registry data from FORCE-TJR to improve the accuracy of risk-adjustment prediction models for thirty-day readmission after total hip replacement and total knee replacement.
The authors argue that registry data offer the opportunity to combine clinical information currently available in registries (such as the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement [FORCE-TJR] registry based at the University of Massachusetts Medical School) with the administrative data currently used by CMS. Doing so will improve the risk adjustment for patients having total joint replacement by making the data more accurate and more fair for hospitals and surgeons.
AHRQ-funded; HS018910.
Citation: Ayers DC, Fehring TK, Odum SM .
Using joint registry data from FORCE-TJR to improve the accuracy of risk-adjustment prediction models for thirty-day readmission after total hip replacement and total knee replacement.
J Bone Joint Surg Am 2015 Apr 15;97(8):668-71. doi: 10.2106/jbjs.n.00889..
Keywords: Registries, Surgery, Hospital Readmissions, Risk
Pradarelli JC, Campbell DA, Dimick JB
Hospital credentialing and privileging of surgeons: a potential safety blind spot.
Taylor v Intuitive, the first of at least 26 lawsuits against Intuitive, went to trial alleging injuries or death tied to the da Vinci Surgical System, a new robotic surgical system. This discussion of the events surrounding the case of Taylor v Intuitive highlights the importance of hospitals’ credentialing and privileging mechanisms for maintaining the quality and safety of surgical care, especially regarding new technologies for which practicing surgeons may not have formal training.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Campbell DA, Dimick JB .
Hospital credentialing and privileging of surgeons: a potential safety blind spot.
JAMA 2015 Apr 7;313(13):1313-4. doi: 10.1001/jama.2015.1943..
Keywords: Patient Safety, Surgery, Education: Continuing Medical Education, Medical Liability, Hospitals
Lewis SS, Dicks KV, Chen LF
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The researchers compared time to diagnosis of invasive surgical site infection (SSI) following hip vs knee arthroplasty. They found that time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume. They hypothesized that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis.
AHRQ-funded; HS023866.
Citation: Lewis SS, Dicks KV, Chen LF .
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
Clin Infect Dis 2015 Apr 1;60(7):990-6. doi: 10.1093/cid/ciu975.
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Keywords: Diagnostic Safety and Quality, Healthcare-Associated Infections (HAIs), Orthopedics, Surgery, Injuries and Wounds, Adverse Events
Kerr EA, Chen J, Sussman JB
Stress testing before low-risk surgery: so many recommendations, so little overuse.
The researchers sought to determine the prevalence of cardiac stress testing before low-risk surgeries, prior to commencement of a campaign to reduce routine stress testing, in order to estimate the potential effect of the campaign on future use of resources. Their study of VA and Medicare patients found that the use of routine preoperative stress testing before low-risk surgeries was very low, suggesting that interventions to further decrease testing would minimally improve quality.
AHRQ-funded; HS018781
Citation: Kerr EA, Chen J, Sussman JB .
Stress testing before low-risk surgery: so many recommendations, so little overuse.
JAMA Intern Med. 2015 Apr;175(4):645-7. doi: 10.1001/jamainternmed.2014.7877..
Keywords: Shared Decision Making, Guidelines, Quality of Care, Healthcare Utilization, Surgery
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
Riall TS, Adhikari D, Parmar AD
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
For older patients with newly diagnosed symptomatic gallstones, researchers calculated their 2-year risk of emergent gallstone-related hospitalization. They found that patients in the high-risk group were less likely to receive elective cholecystectomy than those in the low-risk group. The study used Texas Medicare data for 161,568 patients with an episode of symptomatic gallstones.
AHRQ-funded; HS022134
Citation: Riall TS, Adhikari D, Parmar AD .
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
J Am Coll Surg. 2015 Apr;220(4):682-90. doi: 10.1016/j.jamcollsurg.2014.12.012..
Keywords: Hospitalization, Elderly, Medicare, Surgery
King JT, Perkal MF, Rosenthal RA
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
The researchers explored the current relationship between perioperative mortality and indicators of immune function, anemia, and hypoalbuminemia among HIV-infected and uninfected individuals. Among HIV-infected patients receiving antiretroviral therapy, modern postoperative mortality rates are low and lower CD4 cell counts are associated with increased mortality, but characteristics other than HIV status, such as age and hypoalbuminemia, are also important determinants of outcome.
AHRQ-funded; HS021112.
Citation: King JT, Perkal MF, Rosenthal RA .
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
JAMA Surg 2015 Apr;150(4):343-51. doi: 10.1001/jamasurg.2014.2257..
Keywords: Healthcare Cost and Utilization Project (HCUP), Mortality, Human Immunodeficiency Virus (HIV), Hospitalization, Surgery
Martin BI, Lurie JD, Tosteson AN
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
The authors examined whether published concerns about the safety of bone morphogenetic protein (BMP) altered clinical practice. They found that use of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
AHRQ-funded; HS021695.
Citation: Martin BI, Lurie JD, Tosteson AN .
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Spine J 2015 Apr;15(4):692-9. doi: 10.1016/j.spinee.2014.12.010.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Patient-Centered Outcomes Research, Practice Patterns, Surgery
Bangalore S, Guo Y, Samadashvili Z
Everolimus-eluting stents or bypass surgery for multivessel coronary disease.
Previous studies have shown lower long-term mortality after coronary-artery bypass grafting (CABG) than after percutaneous coronary intervention (PCI) among patients with multivessel disease. The authors evaluated PCI with second-generation drug-eluting stents. They found that the risk of death associated with PCI with everolimus-eluting stents was similar to that associated with CABG. PCI was associated with a higher risk of myocardial infarction (among patients with incomplete revascularization) and repeat revascularization but with a lower risk of stroke.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Everolimus-eluting stents or bypass surgery for multivessel coronary disease.
N Engl J Med 2015 Mar 26;372(13):1213-22. doi: 10.1056/NEJMoa1412168.
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Keywords: Cardiovascular Conditions, Medication, Heart Disease and Health, Surgery
Hartzler AL, Chaudhuri S
Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design.
The researchers share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). Their work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient care and quality improvement.
AHRQ-funded; HS020025.
Citation: Hartzler AL, Chaudhuri S .
Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design.
eGEMS 2015 Mar 13;3(2):1133. doi: 10.13063/2327-9214.1133..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Surgery, Patient-Centered Outcomes Research
Gidengil CA, Predmore Z, Mattke S
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
The purpose of this study was to identify and analyze recently published cases of breast implant-associated anaplastic large cell lymphoma (ALCL), with an emphasis on diagnosis, staging, treatment, and outcomes. The researchers found that, of 54 cases, most patients presented with a seroma, approximately half were associated with the capsule, most presented as stage IE, and all but one case were ALK-negative. Most patients received chemotherapy and radiation therapy, and 11 percent received stem cell transplants. Approximately one-quarter recurred, and 9 percent died.
AHRQ-funded; HS000029.
Citation: Gidengil CA, Predmore Z, Mattke S .
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
Plast Reconstr Surg 2015 Mar;135(3):713-20. doi: 10.1097/prs.0000000000001037.
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Keywords: Adverse Events, Cancer: Breast Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Polsky S, Donahoo WT, Lyons EE
Evaluation of care management intensity and bariatric surgical weight loss.
This study examined the effect of pre- and postoperative care management on weight loss following bariatric surgery. It found no statistically significant associations between either preoperative or postoperative care management intensity and postoperative change in body mass index at year 1 or year 2. Results were limited by heterogeneity of care management across sites and an inability to assess adherence to care management programs.
AHRQ-funded; HS019912.
Citation: Polsky S, Donahoo WT, Lyons EE .
Evaluation of care management intensity and bariatric surgical weight loss.
Am J Manag Care 2015 Mar;21(3):182-9..
Keywords: Care Management, Obesity, Obesity: Weight Management, Patient Adherence/Compliance, Surgery
Hakkarainen TW, Steele SR, Bastaworous A
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
This study evaluated the association between the administration of postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and anastomotic complication rates using a large cohort of patients in a statewide collaborative study. It found that postoperative NSAIDs were associated with a significantly increased risk for anastomotic complications among patients undergoing nonelective colorectal resection.
AHRQ-funded; HS020025
Citation: Hakkarainen TW, Steele SR, Bastaworous A .
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medication, Surgery, Outcomes, Adverse Events
Olsen MA, Nickel KB, Wallace AE
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
The researchers investigated whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. After analyzing a total of 119,973 hernia repair procedures, they found that the incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction necrosis.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Wallace AE .
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
Infect Control Hosp Epidemiol 2015 Mar;36(3):329-35. doi: 10.1017/ice.2014.44..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk, Patient Safety
Lynch TS, Parker RD, Patel RM
The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) research on anterior cruciate ligament reconstruction and orthopaedic practice.
The Multicenter Orthopaedic Outcomes Network consortium was created in 2002 to enroll and longitudinally follow a large population cohort of anterior cruciate ligament reconstructions. The group has helped to establish a new benchmark for conducting multicenter, multisurgeon orthopaedic research. The changes in anterior cruciate ligament reconstruction practice resulting from the group include the use of autograft for high school, college, and competitive athletes.
AHRQ-funded; HS016075.
Citation: Lynch TS, Parker RD, Patel RM .
The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) research on anterior cruciate ligament reconstruction and orthopaedic practice.
J Am Acad Orthop Surg 2015 Mar;23(3):154-63. doi: 10.5435/jaaos-d-14-00005..
Keywords: Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Lee MJ, Shonnard N, Farrokhi F
The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP): a surgeon-led approach to quality and safety.
The researchers sought to identify variation in utilization, processes of care, and outcomes in spine surgery to improve statewide quality and safety. They found significant variability in the indications, process of care, and outcomes related to spine surgery. This variability indicates the need for continued surveillance initiatives and point to opportunities for quality improvement and research.
AHRQ-funded; HS020025.
Citation: Lee MJ, Shonnard N, Farrokhi F .
The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP): a surgeon-led approach to quality and safety.
Spine 2015 Mar 1;40(5):332-41. doi: 10.1097/brs.0000000000000750..
Keywords: Surgery, Quality of Care, Patient Safety, Comparative Effectiveness, Outcomes
Merkow RP, Ju MH, Chung JW
Underlying reasons associated with hospital readmission following surgery in the United States.
The objectives of this study were to characterize the reasons for and timing of readmissions and to examine factors associated with unplanned surgical readmissions. It found that readmissions after surgery were mostly associated with postdischarge complications related to the procedure and not with exacerbation of prior index admission complications.
AHRQ-funded; HS21857.
Citation: Merkow RP, Ju MH, Chung JW .
Underlying reasons associated with hospital readmission following surgery in the United States.
JAMA 2015 Feb 3;313(5):483-95. doi: 10.1001/jama.2014.18614..
Keywords: Surgery, Hospital Readmissions, Injuries and Wounds
Krings JG, Kallogjeri D, Wineland A
Complications following primary and revision transsphenoidal surgeries for pituitary tumors.
This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications.
AHRQ-funded; HS019455.
Citation: Krings JG, Kallogjeri D, Wineland A .
Complications following primary and revision transsphenoidal surgeries for pituitary tumors.
Laryngoscope 2015 Feb;125(2):311-7. doi: 10.1002/lary.24892..
Keywords: Adverse Events, Cancer, Outcomes, Surgery
Hollingsworth JM, Funk RJ, Garrison SA
Differences between physician social networks for cardiac surgery serving communities with high versus low proportions of black residents.
The researchers examined physician social networks, where individual physicians are tied together by a series of shared patients. They mapped these networks using medical claims data from the Medicare program and found substantial differences between physician social networks formed around CABG procedures serving health services areas with high and low proportions of black residents. Their conclusion was that physicians serving these communities are more isolated.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Differences between physician social networks for cardiac surgery serving communities with high versus low proportions of black residents.
Med Care 2015 Feb;53(2):160-7. doi: 10.1097/mlr.0000000000000291..
Keywords: Practice Patterns, Surgery, Heart Disease and Health, Medicare
Turrentine FE, Denlinger CE, Simpson VB
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
The aims of this study were to examine the incidence of anastomotic leaks, a potentially deadly postoperative occurrence following gastrointestinal surgery, to identify risk factors predictive of leaks, and to explore the impact of anastomotic leaks on hospital cost and patient survival. The study demonstrates that anastomotic leaks remain a major source of increased morbidity, mortality, and hospital resource use for gastrointestinal surgery.
AHRQ-funded; HS011913.
Citation: Turrentine FE, Denlinger CE, Simpson VB .
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
J Am Coll Surg 2015 Feb;220(2):195-206. doi: 10.1016/j.jamcollsurg.2014.11.002..
Keywords: Patient Safety, Surgery, Mortality, Healthcare Costs, Adverse Events