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AHRQ Research Studies Date
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- Adverse Drug Events (ADE) (1)
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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 12 of 12 Research Studies DisplayedSharma D
Perioperative management of aneurysmal subarachnoid hemorrhage.
This article discusses aneurysmal subarachnoid hemorrhage, an acute neurologic emergency. Extracranial manifestations of aneurysmal subarachnoid hemorrhage include cardiac dysfunction, neurogenic pulmonary edema, fluid and electrolyte imbalances, and hyperglycemia. The author indicates that prompt definitive treatment of the aneurysm by craniotomy and clipping or endovascular intervention with coils and/or stents is needed to prevent rebleeding. The author also notes that data on the impact of anesthesia on long-term neurologic outcomes of aneurysmal subarachnoid hemorrhage do not exist.
AHRQ-funded; HS026690.
Citation: Sharma D .
Perioperative management of aneurysmal subarachnoid hemorrhage.
Anesthesiology 2020 Dec;133(6):1283-305. doi: 10.1097/aln.0000000000003558..
Keywords: Cardiovascular Conditions, Neurological Disorders, Surgery, Care Management
Mentias A, Briasoulis A, Vaughan Sarrazin MS
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
This longitudinal cohort study examined outcomes of noncardiac surgery (NCS) in patients with left ventricular assist devices (LVADs). This study examined patients enrolled in Medicare who had undergone durable LVAD implantation from January 2012 to November 2017 with follow-up through December 2017. Primary outcome after NCS was major adverse cardiovascular events (MACEs), defined as in-hospital or 30-day all-cause mortality, ischemic stroke, or intracerebral hemorrhage. Of the 8118 patients with LVAD, 1326 underwent NCS with 75.4% emergent or urgent, and 24.6% elective. Both elective and urgent or emergent NCS was associated with higher mortality early and late compared with patients with LVAD who did not undergo NCS.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Vaughan Sarrazin MS .
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
JAMA Netw Open 2020 Nov 2;3(11):e2025118. doi: 10.1001/jamanetworkopen.2020.25118..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices, Chronic Conditions, Outcomes, Adverse Events
Groeneveld PW, Yang L, Segal AG
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
This study examined the effects of market competition and unique regulations on cardiologists’ adoption of transcatheter aortic valve replacement (TAVR). This new technology was introduced around 2012. This retrospective cohort study looked at physician group practices (n=5116) from May 2012 through December 2014. Medicare claim data was used to indicate first usage. The Herfindahl-Hirschman Index was used to show that every 1000 point increase was associated with a 26% relative increase in the rate of TAVR adoption. This was most true in concentrated markets, and adoption of TAVR was favored by physician groups with greater market power.
AHRQ-funded; HS023615.
Citation: Groeneveld PW, Yang L, Segal AG .
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
Med Care 2020 Nov;58(11):996-1003. doi: 10.1097/mlr.0000000000001391..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medicare
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Abraham NS, Yang EH, Noseworthy PA
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
The goal of this study was to compare gastrointestinal bleeding (GIB) rates associated with clopidogrel, prasugrel, and ticagrelor using national medical and pharmacy claims data from privately insured and Medicare Advantage enrollees. Findings showed that, in the first year following percutaneous coronary intervention for acute coronary syndrome, ticagrelor and prasugrel were associated with fewer GIB events compared with clopidogrel.
AHRQ-funded; HS025402.
Citation: Abraham NS, Yang EH, Noseworthy PA .
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
Aliment Pharmacol Ther 2020 Aug;52(4):646-54. doi: 10.1111/apt.15790..
Keywords: Medication: Safety, Medication, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Cardiovascular Conditions, Surgery
Bath J, Smith JB, Kruse RL
Neutrophil-lymphocyte ratio predicts disease severity and outcome after lower extremity procedures.
This study examined the association of neutrophil-lymphocyte ratio (NLR) and complications for patients undergoing interventions for peripheral artery disease (PAD) and other lower extremity conditions. NLR has been associated with higher mortality and other adverse outcomes for those with PAD. The study used inpatients undergoing lower extremity procedures (2008-2016) that were selected from the Cerner Health Facts database (Cerner Corporation, North Kansas City, Mo) using ICD-9 procedure codes. A total of 3687 patients were evaluated, with 2183 undergoing endovascular procedures and 1504 undergoing open procedures. White patients were likely to experience claudication but have less tissue loss. Open procedures had higher NLR rates than endovascular procedures. Preoperative high NLR was strongly associated with in-hospital deaths, cardiac complications, amputation, renal failure, respiratory complications, and prolonged length of stay. Postoperative high NLR values were also associated with more severe PAD.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Neutrophil-lymphocyte ratio predicts disease severity and outcome after lower extremity procedures.
J Vasc Surg 2020 Aug;72(2):622-31. doi: 10.1016/j.jvs.2019.10.094..
Keywords: Surgery, Cardiovascular Conditions, Outcomes, Chronic Conditions
Moon J, Shen L, Likosky DS
Relationship of ventricular morphology and atrioventricular valve function to long-term outcomes following fontan procedures.
This study hypothesized that dysfunction of the single right ventricle (RV) and right atrioventricular valve regurgitation (AVVR) increases over time and adversely impacts late outcomes following a Fontan operation. Through a single-center retrospective study, findings showed that morphologic RV is negatively associated with the long-term survival following the Fontan, possibly due to a tendency toward progressive AVVR and deterioration of the single ventricle function. Additional volume overload caused by AVVR may be one of the main factors accelerating the dysfunction of the single RV, implying that early valve intervention may be warranted.
AHRQ-funded; HS026003.
Citation: Moon J, Shen L, Likosky DS .
Relationship of ventricular morphology and atrioventricular valve function to long-term outcomes following fontan procedures.
J Am Coll Cardiol 2020 Jul 28;76(4):419-31. doi: 10.1016/j.jacc.2020.05.059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes
Dhruva, SS, Parzynski CS, Gamble GM
Attribution of adverse events following coronary stent placement identified using administrative claims data.
This study outlines the process used to identify adverse events following coronary stent placement identified with administrative claims data. Deterministic matching was used to link the National Cardiovascular Data Registry (NCDR) CathPCI Registry to Medicare fee-for-service claims for patients aged 65 and older who underwent percutaneous coronary interventions (PCIs) with drug-eluting stents (DESs) between July 2009 and December 2013. Out of 415,306 DES placements in 368,194 patients, 278 (1.1%) were attributed to the same coronary artery in which the DES was implanted during the index PCI. The authors concluded that more in-depth examination will be needed to accurately assess stent safety using claims data alone.
AHRQ-funded; HS022882.
Citation: Dhruva, SS, Parzynski CS, Gamble GM .
Attribution of adverse events following coronary stent placement identified using administrative claims data.
J Am Heart Assoc 2020 Feb 18;9(4):e013606. doi: 10.1161/jaha.119.013606..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Adverse Events, Registries
Bath J, Kruse RL, Smith JB
Association of postoperative glycemic control with outcomes after carotid procedures.
This study evaluated the relationship between suboptimal glucose control and adverse outcomes after carotid procedures. Patients admitted for elective carotid procedures from 2008-2015 were identified from the Cerner Healthfacts VR database using ICD-9-CM codes. Out of 4287 patients, 87% had optimal postoperative glucose control (80-180 mg/dL). Patients with suboptimal glucose control experienced higher stroke rates, more cardiac complications, longer hospital stays, higher rates of infection, and more complications overall than patients with optimal glucose control.
AHRQ-funded; HS022140.
Citation: Bath J, Kruse RL, Smith JB .
Association of postoperative glycemic control with outcomes after carotid procedures.
Vascular 2020 Feb;28(1):16-24. doi: 10.1177/1708538119866528..
Keywords: Adverse Events, Cardiovascular Conditions, Surgery, Patient-Centered Outcomes Research, Outcomes
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
Chandanabhumma PP, Fetters MD, Pagani FD
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
This paper discusses an ongoing AHRQ-funded study to understand and address variation in health care-associated infections (HAIs) after durable ventricular assist device (VAD) implantation surgery. This procedure is used only on patients with advanced heart failure who have a poor 1-year estimated survival rate. This is a sequential mixed methods study which is conducting a systematic review of HAI prevention studies, and an in-depth quantitative analyses using administration claims, in-depth clinical data, and organizational surveys of VAD centers. The last aim is to develop and disseminate a best practices toolkit for HAI prevention. Data analysis is currently underway.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Fetters MD, Pagani FD .
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
JMIR Res Protoc 2020 Jan 7;9(1):e14701. doi: 10.2196/14701..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Medical Devices, Prevention, Heart Disease and Health, Cardiovascular Conditions, Adverse Events
Song J, Tark A, Larson EL
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. The objective of this integrative review was to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.
AHRQ-funded; HS024915.
Citation: Song J, Tark A, Larson EL .
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Heart Lung 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009..
Keywords: Medical Devices, Cardiovascular Conditions, Surgery, Adverse Events, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk