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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 15 of 15 Research Studies DisplayedWang M, Auerbach A, Oreper SM
Leveraging a new ICD-10 diagnosis code to characterize hospitalized patients with primary sclerosing cholangitis.
Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease, frequently leading to cirrhosis requiring liver transplantation. PSC is typically affects young White males, but with changing demographics of the U.S. population it is not known if demographics of patients with PSC has also changed. Previous research into PSC has been limited by poor validity of diagnostic codes; an International Classification of Diseases (ICD) code was previously utilized to identify several different cholangitic diseases, making accurate identification of PSC patients in large sets of administrative data problematic. A new, PSC-specific ICD-10 code was introduced in 2018 to more accurately identify PSC patients in administrative datasets. The purpose of this study was to leverage the new ICD-10 code in a current cohort of hospitalized PSC patients to describe this population’s demographics and associate them with clinical characteristics and hospitalization outcomes. The study found there are differences in racial/ethnic and gender distribution by age using the new ICD-10 code. The researchers concluded that as use of this code increases over time, future studies should examine reasons for the differences and implications for inpatient/outpatient PSC management. Additional validation of the ICD-10 code is needed to leverage administrative data to further examine PSC demographics, identify disparities, and optimize management and outcomes among all PSC patients.
AHRQ-funded; HS027369.
Citation: Wang M, Auerbach A, Oreper SM .
Leveraging a new ICD-10 diagnosis code to characterize hospitalized patients with primary sclerosing cholangitis.
Clin Gastroenterol Hepatol 2023 Sep; 21(10):2692-94. doi: 10.1016/j.cgh.2022.09.001..
Keywords: Digestive Disease and Health
Brajcich BC, Johnson JK, Holl JL
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
The purpose of this study was to assess the incidence of, reasons for, and predictors of emergency department treat-and-release encounters after gastrointestinal cancer operations. The researchers identified patients who underwent elective colorectal, esophageal, gastric, hepatobiliary, pancreatic, or small intestinal operations for cancer from the 2015-2017 Healthcare Cost and Utilization Project State Inpatient and State Emergency Department Databases for New York, Maryland, and Florida. The study found that among 51,527 patients at 406 hospitals, 7.9% had an ED treat-and-release encounter, and 10.8% had an ED encounter with readmission. In total, 40.7% of ED encounters were treat-and-release encounters. 12% of ED treat-and-release encounters were for pain, 11.7% for device/ostomy complaints, and 11.4% were for wound complaints (11.4%). ED treat-and-release encounters predictors included non-Hispanic Black race/ethnicity and Medicare or Medicaid coverage.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Johnson JK, Holl JL .
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
J Surg Oncol 2023 Aug; 128(2):402-08. doi: 10.1002/jso.27292..
Keywords: Emergency Department, Digestive Disease and Health, Surgery, Hospital Readmissions
Herb J, Rodriguez-Ormaza N, Cunningham C
Gastrostomy tube outcomes among surgical and non-surgical services: a retrospective review.
The purpose of this retrospective analysis study was to evaluate variations in baseline characteristics, complications, and mortality in patients receiving a gastrostomy tube (GT) by surgical or non-surgical services. The researchers assessed adult patients who underwent GT placement from 2014 to 2017 at a single institution. The study found that of the 1,339 adults who underwent GT placement, surgical and non-surgical services performed 45 percent and 55 percent of procedures, respectively. Gastrostomy tube-related complications were similar with 29.6% surgical vs 28.8% non-surgical. The thirty-day mortality rate of 23.7 percent among non-surgical services than the 16.5 percent rate for surgical services.
AHRQ-funded; HS000032.
Citation: Herb J, Rodriguez-Ormaza N, Cunningham C .
Gastrostomy tube outcomes among surgical and non-surgical services: a retrospective review.
Am Surg 2023 Apr; 89(4):813-20. doi: 10.1177/00031348211047173..
Keywords: Surgery, Digestive Disease and Health, Outcomes
Canvasser J, Patel RM, Pryor E
Long-term outcomes and life-impacts of necrotizing enterocolitis: a survey of survivors and parents.
Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition predominantly afflicting preterm infants. Despite its association with unfavorable outcomes within the first two years of life, there is a scarcity of research examining the long-term consequences and life quality in children beyond this age. The purpose of the study was to carry out a survey to assess the enduring repercussions of NEC on physical and psychological well-being, social interactions, and overall life satisfaction as reported by adult survivors and parents of children who overcame NEC. The study found that both survivors and parents of children who have endured NEC encounter persistent challenges affecting their physical and emotional health, social encounters, and overall life contentment.
AHRQ-funded; HS026383
Citation: Canvasser J, Patel RM, Pryor E .
Long-term outcomes and life-impacts of necrotizing enterocolitis: a survey of survivors and parents.
Semin Perinatol 2023 Feb;47(1):151696. doi: 10.1016/j.semperi.2022.151696.
Keywords: Newborns/Infants, Children/Adolescents, Digestive Disease and Health, Outcomes, Quality of Life
Zisman-Ilani Y, Thompson KD, Siegel LS
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
The purpose of this multi-site cluster randomised controlled trial was to test the impact of standard Crohn's disease care and compare with the impact of shared decision making (SDM) on the provider’s choice of therapy, quality of decisions, and provider trust. A total of 158 adult patients with Crohn's disease within 15 years of their diagnosis, with no prior Crohn's disease complications, and who were candidates to receive immunomodulators or biologics, from 14 diverse gastroenterology practices in the US, participated in the study. 99 of those participants received the intervention and 59 received standard care. The study found that participants in the intervention group chose combination therapy more frequently, had a significantly lower decisional conflict, and had greater trust in their provider.
AHRQ-funded; HS021747.
Citation: Zisman-Ilani Y, Thompson KD, Siegel LS .
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
Aliment Pharmacol Ther 2023 Jan;57(2):205-14. doi: 10.1111/apt.17286..
Keywords: Digestive Disease and Health, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication
Nguyen NH, Luo J, Paul P
Effectiveness and safety of biologic therapy in Hispanic vs non-Hispanic patients with inflammatory bowel diseases: a CA-IBD cohort study.
Researchers compared risk of hospitalization, surgery, and serious infection in Hispanic versus non-Hispanic adult patients with inflammatory bowel diseases (IBDs) who were new recipients of biologic therapy. Their findings indicate that Hispanic patients experienced higher hospitalization, surgery, and serious infection rates. The researchers concluded that future studies should investigate the biological, social, and environmental drivers of these differences.
AHRQ-funded; HS019913.
Citation: Nguyen NH, Luo J, Paul P .
Effectiveness and safety of biologic therapy in Hispanic vs non-Hispanic patients with inflammatory bowel diseases: a CA-IBD cohort study.
Clin Gastroenterol Hepatol 2023 Jan;21(1):173-81.e5. doi: 10.1016/j.cgh.2022.05.008..
Keywords: Digestive Disease and Health, Racial and Ethnic Minorities, Treatments
Ingraham NE, King S, Proper J
Morbidity and mortality trends of pancreatitis: an observational study.
The authors assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Using HCUP data, they found that the incidence of pancreatitis, from 2008 to 2015, has increased whereas inpatient mortality has decreased.
AHRQ-funded; HS026732.
Citation: Ingraham NE, King S, Proper J .
Morbidity and mortality trends of pancreatitis: an observational study.
Surg Infect 2021 Dec;22(10):1021-30. doi: 10.1089/sur.2020.473..
Keywords: Healthcare Cost and Utilization Project (HCUP), Digestive Disease and Health, Mortality
Bajaj JS, Shamsaddini A, Acharya C
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
This study’s goal was to define the association of bacterial virulence factors (VFs) with cirrhosis severity and infections, their linkage with outcomes, and impact of fecal microbiota transplant (FMT). This case-control study followed 233 subjects (40 controls, 43 compensated, 30 HE-only (hepatic encephalopathy), 20 ascites-only, 70 both, and 30 infected. Stool samples were collected before and after a 90-day FMT trial. Bacterial species and VFs for all species and selected pathogens (Escherichia, Klebsiella, Pseudomonas, Staphylococcus, Streptococcus, and Enterococcus species) were compared between groups. Decompensated patients, especially those with infections, had higher VFs coding versus the rest. Biofilm and adhesion VFs from Enterobacteriaceae and Enterococcus species were associated with death and hospitalizations independent of clinical factors regardless of when all VFs or selected pathogens were analyzed. FMT was associated with reduced VF post-FMT versus pre-FMT and post-placebo.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Acharya C .
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1993584. doi: 10.1080/19490976.2021.1993584..
Keywords: Digestive Disease and Health
Bajaj JS, Shamsaddini A, Fagan A
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
The authors sought to assess the impact of inhibitory control versus traditional cirrhosis-related cognitive performance on gut microbial composition and function. They found that the gut microbial signature of impaired inhibitory control, which is associated with addictive disorders that can lead to cirrhosis, is distinct from cirrhosis-related cognitive impairment.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Fagan A .
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1953247. doi: 10.1080/19490976.2021.1953247..
Keywords: Digestive Disease and Health
Lumpkin ST, Harvey E, Mihas P
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Researchers investigated effective strategies to reduce unplanned post-discharge health care visits following colorectal surgery (CRS). They found that interview participants voiced clear mental algorithms about when to visit an emergency department, identified facilitators and barriers to optimal health care use, and identified tangible targets for health care utilization reduction efforts. The researchers concluded that efforts should be directed at improving post-discharge communication and care coordination in order to reduce CRS patients' high-resource health care utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Harvey E, Mihas P .
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Qual Health Res 2021 Jul;31(9):1582-95. doi: 10.1177/10497323211002479..
Keywords: Shared Decision Making, Digestive Disease and Health, Surgery
Dos Santos Marques IC, Theiss LM, Wood LN
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
The authors hypothesized that racial disparities exist for Hispanic and Asian patients undergoing surgery for inflammatory bowel disease (IBD). Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) was used. They found that racial disparities do exist among IBD patients undergoing surgery. Black, Hispanic, and Asian IBD patients experience major disparities in post-operative complications, readmissions, and length of stay, respectively, when compared to White patients with IBD. They recommended future research to better understand the mechanisms of these disparities including evaluation of social determinants of health.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Wood LN .
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
Am J Surg 2021 Apr;221(4):668-74. doi: 10.1016/j.amjsurg.2020.12.010..
Keywords: Disparities, Racial and Ethnic Minorities, Surgery, Digestive Disease and Health, Outcomes
Shah SC, Zhu X, Dai Q
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Liver cancer incidence and mortality are escalating globally. Magnesium intake has been studied extensively in nonmalignant liver pathology, but the association between dietary intake of magnesium and primary liver malignancy has not been previously evaluated. In this study, investigators aimed to determine the association between total magnesium intake and primary liver cancer risk. The investigators concluded that based on their prospective cohort analysis, magnesium intake was associated with a lower risk of primary liver cancer, which was more pronounced among moderate and heavy alcohol users.
AHRQ-funded; HS026395.
Citation: Shah SC, Zhu X, Dai Q .
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Am J Clin Nutr 2021 Mar 11;113(3):630-38. doi: 10.1093/ajcn/nqaa326..
Keywords: Cancer, Risk, Digestive Disease and Health, Prevention
Fischer CP, Knapp L, Cohen ME
Feasibility of enhanced recovery in emergency colorectal operation.
This study examines the feasibility of using enhanced recovery pathways (ERPs) in emergency colorectal operations. It has been successfully used with elective surgical care but has not been examined for emergency procedures. A total of 31,511 patients who underwent colorectal operations at 235 hospitals were identified from a national ERP collaborative. Most were elective surgeries (28,425), with 3,086 emergencies. For emergency cases, rates of early Foley removal and venous thromboembolism prophylaxis were highest. Rates of multimodal pain control, early mobilization, and early liquid intake were modest. Patients younger than age 65 years, those with independent functional status, American Society of Anesthesiologists Physical Status Classification 1 to 3, and without physiologic derangement had the most nonadherence. Lack of mobilization or liquid intake was independently associated with increased odds of ileus and prolonged length of stay.
AHRQ-funded; 233201500020I.
Citation: Fischer CP, Knapp L, Cohen ME .
Feasibility of enhanced recovery in emergency colorectal operation.
J Am Coll Surg 2021 Feb;232(2):178-85. doi: 10.1016/j.jamcollsurg.2020.10.004..
Keywords: Surgery, Digestive Disease and Health, Emergency Department, Patient-Centered Outcomes Research, Outcomes
Diaz A, Ricci KB, Rushing AP
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
This study looked at factors linked to emergency surgery practices for small bowel obstruction (SBO) as opposed to non-operative treatment. Data from adult SBO patients from 17 Statewide Inpatient Databases (SIDS) was linked to the authors’ 2015 survey on emergency general surgery (EGS) practices including queries on operating room (OR) availability and surgical staffing. Of the 32,422 SBO patients identified, 83% were treated non-operatively. Operative patients tended to be older, had more comorbidities (53% vs. 46% with 3 or greater), and experienced more systemic complications (36% vs. 23%), higher mortality (2.8% vs. 1.4%), and longer length of stay (median 10 vs. 4 days). Patients had higher odds of operation if they were treated at hospitals with surgeons sometimes or rarely/never covering EGS at more than one location compared to always.
AHRQ-funded; HS022694.
Citation: Diaz A, Ricci KB, Rushing AP .
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
J Gastrointest Surg 2021 Feb;25(2):512-22. doi: 10.1007/s11605-019-04496-3..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Digestive Disease and Health
Lumpkin ST, Mihas P, Baldwin X
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
This mixed methods study looked at patient perspectives on risk factors of non-routine postdischarge care (emergency department visit or rehospitalization) for adult colorectal surgery patients. Surgery patients were identified from hospital records from 2017 to 2018. The authors enrolled 258 participants, surveyed 167, and interviewed 18. Depressive symptoms were found to be one of the many risk factors confirmed to increase non-routine health utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Mihas P, Baldwin X .
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
Am J Surg 2021 Jan;221(1):195-203. doi: 10.1016/j.amjsurg.2020.05.016..
Keywords: Digestive Disease and Health, Surgery, Risk, Hospital Readmissions, Emergency Department