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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 3 of 3 Research Studies DisplayedRomijn AC, Rastogi V, Proaño-Zamudio JA
Early versus delayed thoracic endovascular aortic repair for blunt thoracic aortic injury: a propensity score-matched analysis.
This study examined the outcomes of ≤24 h) versus delayed (>24 h) thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injury (BTAI), taking the aortic injury severity into consideration. Current trauma surgery guidelines recommend delayed TEVAR. Patients undergoing TEVAR for BTAI in the American College of Surgeons Trauma Quality Improvement Program between 2016 and 2019 were included and then stratified into early (≤24 h) or delayed (>24 h). The cohort looked at included 1339 patients, of whom 1054 (79%) underwent early TEVAR. Compared with the delayed group, the early group had significantly less severe head injuries (early vs delayed; 25% vs 32%), fewer early interventions for AAS grade 1 occurred, and AAS grade 3 aortic injuries often were intervened upon within 24 hours (grade 1: 28% vs 47%; grade 3: 49% vs 23%). Compared with the delayed group, the early group had significantly higher in-hospital mortality (8.8% vs 4.4%, relative risk: 2.2, 95% CI: 1.1-4.4), alongside a shorter length of hospital stay (5.0 vs 10 days), a shorter intensive care unit length of stay (4.0 vs 11 days) and fewer days on the ventilator (4.0 vs 6.5 days). Regardless of the higher risk of acute kidney injury in the delayed group (3.3% vs 7.7%), no other differences in in-hospital complications were observed between the early and delayed group.
AHRQ-funded; HS027285.
Citation: Romijn AC, Rastogi V, Proaño-Zamudio JA .
Early versus delayed thoracic endovascular aortic repair for blunt thoracic aortic injury: a propensity score-matched analysis.
Ann Surg 2023 Oct 1; 278(4):e848-e54. doi: 10.1097/sla.0000000000005817..
Keywords: Surgery, Cardiovascular Conditions, Risk, Outcomes
Herzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Howell TC, Lumpkin S, Chaumont N
Predicting colorectal surgery readmission risk: a surgery-specific predictive model.
The purpose of this retrospective split-sample cohort study was to develop a predictive model for colorectal surgery patients for risk of 30-day readmission. The researchers included patients admitted to the colorectal surgery service who underwent surgery and were discharged from an academic tertiary hospital between 2017 and 2019. A total of 1549 patients met eligibility criteria. The study found the 30-day readmission rate of the cohort was 19.62%. Customized surgery-specific readmission models with comprehensive data sources outperformed the most utilized readmission indices in predicting 30-day readmission in colorectal surgery patients. The performance of the models were improved by utilizing more comprehensive datasets that include administrative and socioeconomic details about a patient and clinical information utilized for decision-making at the time of discharge.
AHRQ-funded; HS026363.
Citation: Howell TC, Lumpkin S, Chaumont N .
Predicting colorectal surgery readmission risk: a surgery-specific predictive model.
IISE Trans Healthc Syst Eng 2023; 13(3):175-81. doi: 10.1080/24725579.2023.2200210..
Keywords: Hospital Readmissions, Surgery, Risk