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
126 to 140 of 140 Research Studies DisplayedWang HE, Donnelly JP, Griffin R
Derivation of novel risk prediction scores for community-acquired sepsis and severe sepsis.
The researchers derived and internally validated a Sepsis Risk Score and a Severe Sepsis Risk Score predicting future sepsis and severe sepsis events among community-dwelling adults. They concluded that the Sepsis Risk Score and Severe Sepsis Risk Score predict 10-year sepsis and severe sepsis risk among community-dwelling adults and may aid in sepsis prevention or mitigation efforts.
AHRQ-funded; HS013852.
Citation: Wang HE, Donnelly JP, Griffin R .
Derivation of novel risk prediction scores for community-acquired sepsis and severe sepsis.
Crit Care Med 2016 Jul;44(7):1285-94. doi: 10.1097/ccm.0000000000001666.
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Keywords: Community-Acquired Infections, Risk, Risk, Sepsis
Harrison AM, Gajic O, Pickering BW
Development and implementation of sepsis alert systems.
Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Current evidence does not support routine use of sepsis alert systems in clinical practice. Continuous improvement in the afferent and efferent aspects will help translate theoretic advantages into measurable patient benefit.
AHRQ-funded; HS022799.
Citation: Harrison AM, Gajic O, Pickering BW .
Development and implementation of sepsis alert systems.
Clin Chest Med 2016 Jun;37(2):219-29. doi: 10.1016/j.ccm.2016.01.004..
Keywords: Intensive Care Unit (ICU), Sepsis, Outcomes, Adverse Events
Kessler DO, Walsh B, Whitfill T
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
The authors sought to measure and compare adherence to pediatric sepsis guidelines across a spectrum of emergency departments. They found that among 47 teams across 24 emergency departments, adherent teams had significantly higher Emergency Medical Services for Children readiness scores, MD composition of physicians to total team members, teamwork scores, provider perceptions of pediatric preparedness, and provider perceptions of sepsis preparedness. They concluded that only composite team experience level of the providers was associated with improved guideline adherence.
AHRQ-funded; HS020286.
Citation: Kessler DO, Walsh B, Whitfill T .
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
J Emerg Med 2016 Mar;50(3):403-15.e1-3. doi: 10.1016/j.jemermed.2015.08.004.
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Keywords: Emergency Department, Disparities, Guidelines, Children/Adolescents, Sepsis
Taylor RA, Pare JR, Venkatesh AK
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing clinical decision rules (CDRs) and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. It concluded that this approach outperformed existing CDRs as well as traditional analytic techniques for predicting in-hospital mortality of ED patients with sepsis.
AHRQ-funded; HS021271.
Citation: Taylor RA, Pare JR, Venkatesh AK .
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
Acad Emerg Med 2016 Mar;23(3):269-78. doi: 10.1111/acem.12876.
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Keywords: Emergency Medical Services (EMS), Mortality, Clinical Decision Support (CDS), Sepsis, Health Information Technology (HIT)
Calderwood MS, Vaz LE, Tse Kawai A
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. The researchers evaluated the policy's differential impact in hospitals with high vs low operating margins. They concluded that Medicare's payment policy may have had an impact on reducing central line-associated bloodstream infections in hospitals with low operating margins.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Vaz LE, Tse Kawai A .
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
Infect Control Hosp Epidemiol 2016 Jan;37(1):100-3. doi: 10.1017/ice.2015.250.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Medicare, Quality of Care, Payment, Sepsis
Balamuth F, Weiss SL, Hall M
Identifying pediatric severe sepsis and septic shock: accuracy of diagnosis codes.
The purpose of this study was to evaluate accuracy of 2 established administrative methods of identifying children with sepsis using a medical record review reference standard. It concluded that sepsis specific International Classification of Diseases, Ninth Revision, Clinical Modification codes identify pediatric patients with severe sepsis in administrative data more accurately than a combination of codes for infection plus organ dysfunction.
AHRQ-funded; K08-HS023827.
Citation: Balamuth F, Weiss SL, Hall M .
Identifying pediatric severe sepsis and septic shock: accuracy of diagnosis codes.
J Pediatr 2015 Dec;167(6):1295-300.e4. doi: 10.1016/j.jpeds.2015.09.027.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Sepsis
Kramer RD, Cooke CR, Liu V
Variation in the contents of sepsis bundles and quality measures. a systematic review.
The researchers sought to determine the degree of agreement on component elements of sepsis bundles and the associated timing goals for completion of each element. They also evaluated the amount of variation between metrics associated with bundles. They found that no bundle included metrics evaluating timeliness or completeness of sepsis recognition. Also, there was a lack of consensus on component elements and timing goals across highly recognized sepsis bundles.
AHRQ-funded; HS020672.
Citation: Kramer RD, Cooke CR, Liu V .
Variation in the contents of sepsis bundles and quality measures. a systematic review.
Ann Am Thorac Soc 2015 Nov;12(11):1676-84. doi: 10.1513/AnnalsATS.201503-163BC.
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Keywords: Sepsis, Mortality, Guidelines, Antimicrobial Stewardship, Outcomes
Donnelly JP, Hohmann SF, Wang HE
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
The researchers sought to characterize 7- and 30-day readmission rates following hospital admission for severe sepsis as well as institutional variations in readmission. They concluded that severe sepsis readmission places a substantial burden on the healthcare system, with one in 15 and one in five severe sepsis discharges readmitted within 7 and 30 days, respectively.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Hohmann SF, Wang HE .
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
Crit Care Med 2015 Sep;43(9):1916-27. doi: 10.1097/ccm.0000000000001147..
Keywords: Hospital Readmissions, Hospitals, Risk, Sepsis
Wang HE, Donnelly JP, Shapiro NI
Hospital variations in severe sepsis mortality.
The authors characterized variations in severe sepsis mortality between hospitals in the United States. They used hospital discharge data from the University HealthSystem Consortium and found variations in institutional severe sepsis observed mortality rates and observed-to-expected mortality ratios.
AHRQ-funded; HS019465; HS013852.
Citation: Wang HE, Donnelly JP, Shapiro NI .
Hospital variations in severe sepsis mortality.
Am J Med Qual 2015 Jul-Aug;30(4):328-36. doi: 10.1177/1062860614534461.
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Keywords: Data, Hospitals, Mortality, Patient-Centered Outcomes Research, Sepsis
Makam AN, Nguyen OK, Auerbach AD
Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review.
This review aimed to determine whether automated real-time electronic sepsis alerts can: (1) accurately identify sepsis and (2) improve process measures and outcomes. It found that automated sepsis alerts derived from electronic health data may improve care processes but tend to have poor positive predictive value and do not improve mortality or length of stay.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Auerbach AD .
Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review.
J Hosp Med 2015 Jun;10(6):396-402. doi: 10.1002/jhm.2347..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Sepsis, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Kane-Gill SL, Sileanu FE, Murugan R
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
The authors sought to delineate the determinants of risk for acute kidney injury (AKI) in older compared with younger adults. They found that among the risk factors for AKI in the oldest age category were drugs (vancomycin, aminoglycosides, and nonsteroidal anti-inflammatories), history of hypertension, and sepsis. Fewer variables remained predictive of AKI as age increased and the model for older patients was less predictive.
AHRQ-funded; HS018721.
Citation: Kane-Gill SL, Sileanu FE, Murugan R .
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
Am J Kidney Dis 2015 Jun;65(6):860-9. doi: 10.1053/j.ajkd.2014.10.018.
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Keywords: Elderly, Kidney Disease and Health, Medication, Risk, Sepsis
Powell TC, Donnelly JP, Gutierrez OM
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
The researchers sought to determine the association between elevated baseline Cyst-C and long-term rates of community-acquired sepsis. They found that elevated Cyst-C is associated with increased long-term rates of community-acquired sepsis, independent of abnormal eGFR, ACR or hsCRP. Cyst-C may play a role in long-term sepsis risk prediction and prevention.
AHRQ-funded; HS013852.
Citation: Powell TC, Donnelly JP, Gutierrez OM .
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
BMC Nephrol 2015 Apr 23;16:61. doi: 10.1186/s12882-015-0055-z..
Keywords: Community-Acquired Infections, Kidney Disease and Health, Risk, Sepsis
Wang HE, Addis DR, Donnelly JP
Discharge diagnoses versus medical record review in the identification of community-acquired sepsis.
The researchers evaluated the accuracy of hospital discharge diagnoses in the identification of community-acquired sepsis and severe sepsis. They found that hospital discharge diagnoses show good specificity but poor sensitivity for detecting community-acquired sepsis and severe sepsis.
AHRQ-funded; HS013852.
Citation: Wang HE, Addis DR, Donnelly JP .
Discharge diagnoses versus medical record review in the identification of community-acquired sepsis.
Crit Care 2015 Feb 16;19:42. doi: 10.1186/s13054-015-0771-6.
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Keywords: Community-Acquired Infections, Diagnostic Safety and Quality, Hospital Discharge, Sepsis
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis
Septimus EJ, Hayden MK, Kleinman K
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
The investigators determined rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. They demonstrated that universal decolonization with mupirocin and chlorhexidine bathing resulted in a significant reduction in blood culture contamination.
AHRQ-funded; 290201000008I; 290032007T.
Citation: Septimus EJ, Hayden MK, Kleinman K .
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S17-22. doi: 10.1086/677822.
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Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Sepsis