National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
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- Blood Thinners (5)
- Cancer (1)
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- Comparative Effectiveness (3)
- Data (3)
- Depression (2)
- Diagnostic Safety and Quality (3)
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- Elderly (7)
- Electronic Health Records (EHRs) (2)
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- Evidence-Based Practice (4)
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- (-) Heart Disease and Health (64)
- Hospital Discharge (1)
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- Newborns/Infants (1)
- Nutrition (1)
- Obesity: Weight Management (1)
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- Patient-Centered Outcomes Research (13)
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- Practice Patterns (2)
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- Public Reporting (1)
- Quality Indicators (QIs) (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (4)
- Registries (6)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (10)
- Sex Factors (4)
- Shared Decision Making (2)
- Sleep Problems (1)
- Social Determinants of Health (4)
- Stress (1)
- Stroke (5)
- Surgery (6)
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 64 Research Studies DisplayedChen R, Strait KM, Dharmarajan K
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
This study investigates how contemporary hospitals use this resource-intensive setting of intensive care units (ICUs) and whether higher use is associated with better outcomes. It found that rates of ICU admission for patients with AMI vary substantially across hospitals and were not associated with differences in mortality, but were associated with greater use of critical care therapies.
AHRQ-funded; HS020672.
Citation: Chen R, Strait KM, Dharmarajan K .
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
Am Heart J 2015 Dec;170(6):1161-9. doi: 10.1016/j.ahj.2015.09.003.
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Keywords: Hospitalization, Intensive Care Unit (ICU), Heart Disease and Health
Desai NR, Parzynski CS, Krumholz HM
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
The researchers sought to determine whether internal review of percutaneous coronary intervention (PCI) appropriateness using appropriate use criteria is associated with differences in procedural appropriateness, quality of care, and patient outcomes. They concluded that there was a modest association between procedural appropriateness and clinical outcomes and a similarly modest correlation between nonacute PCI volume and procedural appropriateness.
AHRQ-funded; HS023000
Citation: Desai NR, Parzynski CS, Krumholz HM .
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
JAMA Intern Med. 2015 Dec;175(12):1988-90.
Keywords: Cardiovascular Conditions, Patient-Centered Outcomes Research, Heart Disease and Health, Registries
Chen SI, Wang Y, Dreyer R
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
The authors assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients with acute myocardial infarction (AMI) in the US and in Spain. They concluded that in the US, women were more likely than men to delay, although it was not explained by differences in insurance status. Further, the lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture.
AHRQ-funded; HS023000.
Citation: Chen SI, Wang Y, Dreyer R .
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
Am J Cardiol 2015 Dec 15;116(12):1827-32. doi: 10.1016/j.amjcard.2015.09.018.
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Keywords: Healthcare Delivery, Emergency Medical Services (EMS), Health Insurance, Heart Disease and Health, Sex Factors
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Panahiazar M, Taslimitehrani V, Pereira NL
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
The authors developed a multidimensional patient similarity assessment technique that leverages multiple types of information from the electronic health records and predicts a medication plan for each new patient based on prior knowledge and data from similar patients.Their findings suggest that it is feasible to harness population-based information for an individual patient-specific assessment.
AHRQ-funded; HS023077.
Citation: Panahiazar M, Taslimitehrani V, Pereira NL .
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
Stud Health Technol Inform 2015;210:369-73.
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Keywords: Clinical Decision Support (CDS), Data, Electronic Health Records (EHRs), Heart Disease and Health, Patient-Centered Healthcare
Desai NR, Bradley SM, Parzynski CS
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
The researchers examined trends in percutaneous coronary intervention (PCI) utilization, patient selection, and procedural appropriateness following the introduction of Appropriate Use Criteria. They concluded that there have been significant reductions in the volume of nonacute PCI. The proportion of nonacute PCIs classified as inappropriate has declined, although hospital-level variation in inappropriate PCI persists.
AHRQ-funded; HS023000.
Citation: Desai NR, Bradley SM, Parzynski CS .
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
JAMA 2015 Nov 17;314(19):2045-53. doi: 10.1001/jama.2015.13764.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Utilization
Cooper LB, Hammill BG, Peterson ED
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
No large studies have examined whether laboratory monitoring occurs routinely in community practice. The researchers observed low rates of monitoring in clinical practice: after initiation of mineralocorticoid receptor antagonist therapy in a large cohort, only 1,384 patients (13.3 percent) and 3,122 patients (29.9 percent) received appropriate testing in early and extended follow-up, respectively.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
JAMA 2015 Nov 10;314(18):1973-5. doi: 10.1001/jama.2015.11904..
Keywords: Heart Disease and Health, Cardiovascular Conditions
Spatz ES, Curry LA, Masoudi FA
The variation in recovery: role of gender on outcomes of young AMI Patients (VIRGO) classification system: a taxonomy for young women with acute myocardial infarction.
The authors developed a novel taxonomy among adults up to age 55 with acute myocardial infarction (AMI) enrolled in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study. They found that approximately 1 in 8 young women with AMI is unclassified by the Universal Definition of MI. They proposed a more inclusive taxonomy that could serve as a framework for understanding biological disease mechanisms, therapeutic efficacy, and prognosis in this population.
AHRQ-funded; HS023000.
Citation: Spatz ES, Curry LA, Masoudi FA .
The variation in recovery: role of gender on outcomes of young AMI Patients (VIRGO) classification system: a taxonomy for young women with acute myocardial infarction.
Circulation 2015 Nov 3;132(18):1710-8. doi: 10.1161/circulationaha.115.016502.
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Keywords: Diagnostic Safety and Quality, Heart Disease and Health, Sex Factors
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication
Goyal A, de Lemos JA, Peng SA
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
The researchers investigated whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). They found that only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees.
AHRQ-funded; HS021092.
Citation: Goyal A, de Lemos JA, Peng SA .
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):567-75. doi: 10.1161/circoutcomes.115.001650.
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Keywords: Heart Disease and Health, Medicare, Patient-Centered Outcomes Research, Medication, Patient Adherence/Compliance
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
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Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Silverberg JI
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
The authors sought to determine whether adult eczema is associated with increased cardiovascular and cerebrovascular disease. They concluded that adults with atopic dermatitis may have increased cardiovascular disease, heart attack, and stroke.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
Allergy 2015 Oct;70(10):1300-8. doi: 10.1111/all.12685.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Cancer: Skin Cancer
Burns KM, Encinosa WE, Pearson GD
AHRQ Author: Encinosa WE
Electrocardiogram in preparticipation athletic evaluations among insured youths.
The researchers retrospectively characterized electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). They found that thirteen percent of PPEs with ECG and 0.5 percent of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18 percent (2 percent sports-limiting); after PPEs alone, cardiac disease was identified in 0.5 percent (0.03 percent sports-limiting).
AHRQ-authored.
Citation: Burns KM, Encinosa WE, Pearson GD .
Electrocardiogram in preparticipation athletic evaluations among insured youths.
J Pediatr 2015 Oct;167(4):804-09.e1. doi: 10.1016/j.jpeds.2015.06.011..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Hurst DM, Oster ME, Smith S
Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on Congenital Heart Disease National Pediatric Cardiology Quality Improvement Collaborative (JCCHD-NPCQIC).
The researchers sought to determine whether frequency of outpatient clinic visits correlated with weight gain in patients with hypoplastic left heart syndrome or variant during the interstage period between discharge from stage I palliation and presentation for stage II palliation . There was no correlation between interstage visit frequency and change in weight-for-age z-score in this patient population.
AHRQ-funded; HS016957.
Citation: Hurst DM, Oster ME, Smith S .
Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on Congenital Heart Disease National Pediatric Cardiology Quality Improvement Collaborative (JCCHD-NPCQIC).
Pediatr Cardiol 2015 Oct;36(7):1382-5. doi: 10.1007/s00246-015-1169-6.
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Keywords: Newborns/Infants, Obesity: Weight Management, Heart Disease and Health, Ambulatory Care and Surgery
Doll JA, Hellkamp A, Ho PM
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
This study identified opportunities to improve the use of cardiac rehabilitation by older adults. It concluded that quality improvement efforts should focus not only on increasing referral rates but also on addressing barriers to attending rehabilitation sessions, such as travel distance, copayments, and lack of coordination between inpatient and outpatient clinicians.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp A, Ho PM .
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
JAMA Intern Med 2015 Oct;175(10):1700-2. doi: 10.1001/jamainternmed.2015.3819..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions
Desai NR, Sabatine MS
PCSK9 inhibition in patients with hypercholesterolemia.
The authors specified that large, cardiovascular outcomes trials are underway to assess definitively the efficacy and safety of 3 monoclonal antibodies (evolocumab, alirocumab, and bococizumab), while additional non-monoclonal antibody approaches to inhibit PCSK9 continue in the early-phase development.
AHRQ-funded; HS023000.
Citation: Desai NR, Sabatine MS .
PCSK9 inhibition in patients with hypercholesterolemia.
Trends Cardiovasc Med 2015 Oct;25(7):567-74. doi: 10.1016/j.tcm.2015.01.009.
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Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research
Sentell T, Miyamura J, Ahn HJ
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
The authors studied congestive heart failure (CHF) hospitalizations among racial groups. They found that high preventable CHF hospitalization rates are seen in some Asian and Pacific Islander groups, especially Native Hawaiians and Filipinos, who have these hospitalizations at younger ages than other studied groups.
AHRQ-funded; HS019990.
Citation: Sentell T, Miyamura J, Ahn HJ .
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
J Immigr Minor Health 2015 Oct;17(5):1289-97. doi: 10.1007/s10903-014-0098-4.
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Keywords: Heart Disease and Health, Hospitalization, Prevention, Racial and Ethnic Minorities, Social Determinants of Health
Carls GS, Henke RM, Karaca Z
AHRQ Author: Karaca Z, Wong HS
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
The researchers assessed the association between unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995–2011. They found that for both adults and seniors, a 1 percent increase in the unemployment rate was associated with a statistically significant decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Carls GS, Henke RM, Karaca Z .
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
Health Serv Res 2015 Oct;50(5):1688-709. doi: 10.1111/1475-6773.12298..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Healthcare Utilization, Hospitalization
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
This study evaluated outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with chronic kidney disease (CKD). It found that In patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps heart attack, with no long-term mortality difference.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
J Am Coll Cardiol 2015 Sep 15;66(11):1209-20. doi: 10.1016/j.jacc.2015.06.1334..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Surgery, Kidney Disease and Health
Blumenthal-Barby JS, Kostick KM, Delgado ED
Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: implications for informed consent and shared decision-making.
The authors investigated the decision-making process and informational and decisional needs of patients and their caregivers regarding left ventricular assist device (LVAD) placement. They found that participants easily and clearly identified their values: life extension; family; and mobility. Participants reported the need to meet other patients and caregivers before device placement and to have an involved caregiver to synthesize information. They further found that some participants demonstrated a lack of clarity regarding transplant probability.
AHRQ-funded; HS024849.
Citation: Blumenthal-Barby JS, Kostick KM, Delgado ED .
Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: implications for informed consent and shared decision-making.
J Heart Lung Transplant 2015 Sep;34(9):1182-9. doi: 10.1016/j.healun.2015.03.026.
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Keywords: Caregiving, Shared Decision Making, Heart Disease and Health, Medical Devices, Patient and Family Engagement
Zhang H, Masoudi FA, Li J
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
The objective of this study was to perform a national quality assessment of early β-blocker use during hospitalization for AMI over the past decade in China. It found that the use of early β-blocker therapy for patients with AMI in China is suboptimal, with underuse in patients who could benefit and substantial use among those who might be harmed.
AHRQ-funded; HS023000.
Citation: Zhang H, Masoudi FA, Li J .
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
Am Heart J 2015 Sep;170(3):506-15.e1. doi: 10.1016/j.ahj.2015.05.012..
Keywords: Heart Disease and Health, Hospitalization, Patient-Centered Outcomes Research, Quality of Care
Hess CN, Peterson ED, Peng SA
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
The authors sought to determine appropriate antithrombotic therapy for acute myocardial infarction (MI) patients with atrial fibrillation (AF) treated with percutaneous coronary intervention (PCI). They found that approximately 1 in 4 older AF patients undergoing PCI for MI were discharged on triple therapy. Those receiving triple therapy versus dual antiplatelet therapy had higher rates of major bleeding without a measurable difference in composite MI, death, or stroke.
AHRQ-funded; HS021092.
Citation: Hess CN, Peterson ED, Peng SA .
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
J Am Coll Cardiol 2015 Aug 11;66(6):616-27. doi: 10.1016/j.jacc.2015.05.062.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication
Kaplan RM, Irvin VL
AHRQ Author: Kaplan RM
Likelihood of null effects of large NHLBI clinical trials has increased over time.
This study explores whether the number of null results in large National Heart Lung, and Blood Institute (NHLBI) funded trials has increased over time. It found that the number NHLBI trials reporting positive results declined after the year 2000. Prospective declaration of outcomes in RCTs, and the adoption of transparent reporting standards, as required by clinicaltrials.gov, may have contributed to the trend toward null findings.
AHRQ-authored
Citation: Kaplan RM, Irvin VL .
Likelihood of null effects of large NHLBI clinical trials has increased over time.
PLoS One 2015 Aug 5;10(8):e0132382. doi: 10.1371/journal.pone.0132382..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Registries
Lim E, Cheng Y, Reuschel C
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
This study examined the impact of key laboratory and race/ethnicity data on the prediction of in-hospital mortality for congestive heart failure (CHF) and acute myocardial infarction (AMI). It found that adding a simple three-level summary measure based on the number of abnormal laboratory data observed to hospital administrative claims data significantly improved the model prediction for inpatient mortality.
AHRQ-funded; HS019990.
Citation: Lim E, Cheng Y, Reuschel C .
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
Health Serv Res 2015 Aug;50 Suppl 1:1351-71. doi: 10.1111/1475-6773.12325..
Keywords: Heart Disease and Health, Mortality, Data, Inpatient Care
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords: Sleep Problems, Surgery, Patient Safety, Risk, Heart Disease and Health, Respiratory Conditions, Chronic Conditions