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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.
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1 to 3 of 3 Research Studies DisplayedAnesi GL, Dres E, Chowdhury M
Among-hospital variation in ICU admission practices and associated outcomes for patients with acute respiratory failure.
Prior research has demonstrated a connection between hospital strain and ICU admission, and has suggested that ICU admission, compared to ward admission, could be advantageous for certain patients with acute respiratory failure (ARF). The purpose of this study was to explore how strain-process-outcomes relationships in ARF patients may differ among hospitals and to identify hospital practice discrepancies that may explain such variation. The researchers analyzed high-acuity ARF patients who did not necessitate mechanical ventilation or vasopressors in the emergency department (ED) and were admitted to 27 US hospitals between 2013 and 2018. The researchers compared hospital strain-ICU admission relationships and hospital length of stay (LOS) and mortality for patients initially admitted to the ICU versus the ward. Additionally, they investigated hospital practices and assessed their associations with those processes and outcomes. The study found that substantial variation was observed among hospitals in ICU admission rates, hospital strain-ICU admission relationships, and the impact of ICU admission on hospital LOS and mortality. Overall, ED patients with ARF had a median hospital LOS that was 0.82 days shorter if initially admitted to the ICU rather than the ward. However, among the 27 hospitals this effect ranged from 5.85 days shorter to 4.38 days longer. In exploratory analyses, only a limited number of identified hospital practices—such as the presence of sepsis ED disposition guidelines and maximum ED patient capacity—were potentially linked to hospital strain-ICU admission relationships.
AHRQ-funded; HS026372.
Citation: Anesi GL, Dres E, Chowdhury M .
Among-hospital variation in ICU admission practices and associated outcomes for patients with acute respiratory failure.
Ann Am Thorac Soc 2023 Mar; 20(3):406-13. doi: 10.1513/AnnalsATS.202205-429OC.
Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Hospital Discharge
Wong EG, Parker AM, Leung DG
Association of severity of illness and intensive care unit readmission: a systematic review.
This study sought to determine whether ICU readmission is associated with higher severity of illness scores in adult patients. In most of the 31 studies included in the analysis, severity of illness scores were higher in patients readmitted to the ICU. Readmission was also associated with higher mortality and longer ICU and hospital stays.
AHRQ-funded; HS022916.
Citation: Wong EG, Parker AM, Leung DG .
Association of severity of illness and intensive care unit readmission: a systematic review.
Heart Lung 2016 Jan-Feb;45(1):3-9.e2. doi: 10.1016/j.hrtlng.2015.10.040.
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Keywords: Intensive Care Unit (ICU), Hospital Readmissions, Hospital Discharge, Outcomes
Wagner J, Gabler NB, Ratcliffe SJ
Outcomes among patients discharged from busy intensive care units.
This study of 155 U.S. intensive care units (ICUs) found that when their capacities are strained, triage decisions seem to be affected such that patients are discharged from the ICU more quickly, and have slightly greater odds of being readmitted to the ICU. However, short-term patient outcomes are unaffected.
AHRQ-funded; HS018406
Citation: Wagner J, Gabler NB, Ratcliffe SJ .
Outcomes among patients discharged from busy intensive care units.
Ann Intern Med. 2013 Oct 1;159(7):447-55. doi: 10.7326/0003-4819-159-7-201310010-00004..
Keywords: Intensive Care Unit (ICU), Patient Safety, Outcomes, Hospital Discharge, Mortality