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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 4 of 4 Research Studies DisplayedBowman JA, Nuño M, Jurkovich GJ
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
Researchers characterized interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and evaluated whether greater hospital-level use of ICU admission is associated with improved outcomes. This study included trauma patients who were admitted to trauma centers participating in the National Trauma Data Bank. The researchers found that admission location of older patients with isolated rib fractures was variable across hospitals, but hospitalization at a center with greater ICU use was associated with improved outcomes. They recommended that hospitals with low ICU use admit more such patients to an ICU.
AHRQ-funded; HS022236.
Citation: Bowman JA, Nuño M, Jurkovich GJ .
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
JAMA Netw Open 2020 Nov 2;3(11):e2026500. doi: 10.1001/jamanetworkopen.2020.26500..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Hospitals, Patient-Centered Outcomes Research, Outcomes, Mortality
Bowman JA, Jurkovich GJ, Nuño M
Hospital-level intensive care unit admission for patients with isolated blunt abdominal solid organ injury.
This study’s objective was to determine the optimal level of care for hemodynamically stable patients with isolated blunt hepatic, renal, or splenic injuries. A retrospective cohort study was conducted using the 2015 and 2016 National Trauma Data Bank. The intervariability of intensive care unit (ICU) admission for these patients was determined. Hospitals were categorized into quartiles based on the proportion of eligible patients admitted to an ICU. Primary outcomes were a composite of organ failure, infection, or death during hospitalization. Findings were that greater hospital-level ICU use was not associated with a decreased likelihood of the composite outcome or infection or death. These outcomes were fairly rare to begin with.
AHRQ-funded; HS022236.
Citation: Bowman JA, Jurkovich GJ, Nuño M .
Hospital-level intensive care unit admission for patients with isolated blunt abdominal solid organ injury.
J Trauma Acute Care Surg 2020 Mar;88(3):408-15. doi: 10.1097/ta.0000000000002581.
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Keywords: Injuries and Wounds, Intensive Care Unit (ICU), Critical Care, Patient-Centered Outcomes Research, Evidence-Based Practice
Bowman JA, Jurkovich GJ, Nishijima DK
Older adults with isolated rib fractures do not require routine intensive care unit admission.
This study examined whether older adults with isolated rib fractures should be admitted to an intensive care unit (ICU) due to higher presumed morbidity and mortality. Patients 50 years and older who were admitted between 2013 and 2017 were analyzed. The outcomes being looked at were any critical care intervention or adverse event based on accepted critical care guidelines. Out of 401 patients, 251 (63%) were admitted to the ICU. In the ICU, 33% experienced an adverse event while only 7% admitted to the ward experienced an adverse event. The most common events were hypotension, frequent respiratory therapy and oxygen desaturation. Predictors of these events included incentive spirometry, use of a walker, increased chest Abbreviated Injury Scale score, age 72 or greater, and active smoking. The investigators concluded routine ICU admission is not necessary for most older adults with isolated rib fractures.
AHRQ-funded; HS022236.
Citation: Bowman JA, Jurkovich GJ, Nishijima DK .
Older adults with isolated rib fractures do not require routine intensive care unit admission.
J Surg Res 2020 Jan;245:492-99. doi: 10.1016/j.jss.2019.07.098..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Outcomes
Bunnell KL, Zullo AR, Collins C
Methicillin-resistant staphylococcus aureus pneumonia in critically ill trauma and burn patients: a retrospective cohort study.
The authors sought to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU). They found that the 11.4% overall incidence of MRSA pneumonia in the studied trauma-burn cohort was similar to what has been reported in other trauma populations, although MRSA was equally likely to be identified in early- and late-onset pneumonia. They suggested that risk factors other than duration of hospitalization may be important considerations in the decision to initiate MRSA-active empiric therapy for pneumonia in the trauma-burn ICU.
AHRQ-funded; HS022998.
Citation: Bunnell KL, Zullo AR, Collins C .
Methicillin-resistant staphylococcus aureus pneumonia in critically ill trauma and burn patients: a retrospective cohort study.
Surg Infect 2017 Feb/Mar;18(2):196-201. doi: 10.1089/sur.2016.115.
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Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA)