National Healthcare Quality and Disparities Report
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Topics
- Antibiotics (1)
- Clostridium difficile Infections (1)
- (-) Community-Acquired Infections (11)
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- Elderly (3)
- Emergency Department (1)
- Home Healthcare (2)
- Hospitalization (1)
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- Pneumonia (3)
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- Provider: Nurse (1)
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- Sepsis (3)
- Stroke (1)
- Urinary Tract Infection (UTI) (1)
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 11 of 11 Research Studies DisplayedRothberg MB, Haessler S, Deshpande A
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
The purpose of this study was to develop and validate a model for risk of resistance to first-line community-acquired pneumonia (CAP) therapy. The study was conducted using data for adults hospitalized for CAP from 177 Premier Healthcare database hospitals and 11 Cleveland Clinic hospitals. The study found that among 138,762 eligible patients in the Premier database, 8.8% had positive cultures and 3.8% had organisms resistant to CAP therapy. The strongest predictor of resistance was infection with a resistant organism in the previous year. Markers of acute illness such as receipt of mechanical ventilation or vasopressors, and chronic illness such as pressure ulcer or paralysis were also related with resistant infections. The study model outperformed the Drug Resistance in Pneumonia (DRIP) model in the Premier holdout sample, the Cleveland Clinic hospitals sample. Clinicians at Premier facilities utilized broad-spectrum antibiotics for 20%-30% of their patients. In discriminating between patients with and without resistant infections, physician judgment slightly outperformed the DRIP instrument but not the study model.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Haessler S, Deshpande A .
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jul; 44(7):1143-50. doi: 10.1017/ice.2022.229..
Keywords: Community-Acquired Infections, Pneumonia, Risk
Russell D, Dowding D, Trifilio M
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
This paper is a study of nurse perceptions of individual, social, and environmental factors for infection risk among home healthcare (HHC) patients and also identifies the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017-2018 from qualitative interviews with 50 HHC nurses and structured observations of nurse visits to patients’ homes (n = 400). Perceived infection risk among patients was characterized as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Frequent environmental barriers observed during visits to patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%).
AHRQ-funded; HS024723.
Citation: Russell D, Dowding D, Trifilio M .
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
Health Soc Care Community 2021 May;29(3):780-88. doi: 10.1111/hsc.13321..
Keywords: Home Healthcare, Community-Acquired Infections, Risk, Provider: Nurse, Provider
O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W
Reopening businesses and risk of COVID-19 transmission.
In this paper, the authors used anonymized cell-phone data to quantify the potential risk of COVID-19 transmission in business establishments by building a Business Risk Index that measures transmission risk over time. They used two metrics, visits per square foot and the average duration of visits from January 2020 to June 2020. They found that an increase in a county's average Business Risk Index is associated with an increase in positive COVID-19 cases in 1 week. Their risk index provides a way for policymakers and hospital decision-makers to monitor the potential risk of COVID-19 transmission from businesses based on the frequency and density of visits to businesses.
AHRQ-funded; HS024288.
Citation: O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W .
Reopening businesses and risk of COVID-19 transmission.
NPJ Digit Med 2021 Mar 16;4(1):51. doi: 10.1038/s41746-021-00420-9..
Keywords: COVID-19, Community-Acquired Infections, Public Health, Risk
Shang J, Russell D, Dowding D
A predictive risk model for infection-related hospitalization among home healthcare patients.
Infection prevention is a high priority for home healthcare (HHC), but tools are lacking to identify patients at highest risk of developing infections. The purpose of this study was to develop and test a predictive risk model to identify HHC patients at risk of an infection-related hospitalization or emergency department visit. A nonexperimental study using secondary data was conducted.
AHRQ-funded; HS024723.
Citation: Shang J, Russell D, Dowding D .
A predictive risk model for infection-related hospitalization among home healthcare patients.
J Healthc Qual 2020 May/Jun;42(3):136-47. doi: 10.1097/jhq.0000000000000214..
Keywords: Elderly, Home Healthcare, Infectious Diseases, Community-Acquired Infections, Risk, Hospitalization, Emergency Department
Obodozie-Ofoegbu OO, Teng C, Mortensen EM
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Infectious Diseases Society of America guidelines recommend empiric antipseudomonal combination therapy when Pseudomonas is suspected. However, combination antipseudomonal therapy is controversial. This population-based retrospective cohort study compared all-cause 30-day mortality in older patients who received antipseudomonal monotherapy (PMT) or antipseudomonal combination therapy (PCT) for the treatment of community-onset pneumonia. The investigators found that older adults who received combination antipseudomonal therapy for community-onset pneumonia fared worse than those who received monotherapy.
AHRQ-funded; HS022418.
Citation: Obodozie-Ofoegbu OO, Teng C, Mortensen EM .
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Am J Infect Control 2019 Sep;47(9):1053-58. doi: 10.1016/j.ajic.2019.02.018..
Keywords: Antibiotics, Community-Acquired Infections, Elderly, Infectious Diseases, Medication, Pneumonia, Risk
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Weinstein EJ, Han JH, Lautenbach E
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Researchers sought to create a clinical prediction tool for community-onset urinary tract infections (UTIs) due to extended-spectrum cephalosporin-resistant (ESC-R) Enterobacterales (EB). Study participants included patients who presented to an emergency department or outpatient practice with an EB UTI; case patients had ESC-R EB UTIs and control patients had ESC-susceptible EB UTIs. The predictive model was develop by performing a multivariable conditional logistic regression. The researchers found after multivariable analysis that presentation with an ESC-R EB community-onset UTI could be predicted by the following factors: history of malignancy, history of diabetes, recent skilled nursing facility or hospital stay, recent trimethoprim-sulfamethoxazole exposure, pyelonephritis at the time of presentation. They conclude that community-onset ESC-R EB UTI can be predicted by using the proposed scoring system, which can be helpful to guide diagnostic and therapeutic interventions.
AHRQ-funded; HS020002.
Citation: Weinstein EJ, Han JH, Lautenbach E .
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Open Forum Infect Dis 2019 Apr;6(4):ofz164. doi: 10.1093/ofid/ofz164..
Keywords: Community-Acquired Infections, Risk, Urinary Tract Infection (UTI)
Anderson DJ, Rojas LF, Watson S
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. This study found that proximity to a livestock farm (0.01), proximity to farming raw materials services (0.02), and proximity to a nursing home (0.04) were independently associated with increased rates of CA-CDI.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Rojas LF, Watson S .
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
PLoS One 2017 May 16;12(5):e0176285. doi: 10.1371/journal.pone.0176285.
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Keywords: Clostridium difficile Infections, Community-Acquired Infections, Risk, Patient Safety
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
AHRQ-funded; HS022418.
Citation: Frei CR, Rehani S, Lee GC .
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
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Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Wang 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
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