National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- (-) Blood Clots (10)
- Blood Pressure (1)
- Blood Thinners (4)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- COVID-19 (1)
- Diabetes (1)
- Education: Continuing Medical Education (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (1)
- Inpatient Care (2)
- Maternal Care (1)
- Medication (5)
- Medication: Safety (1)
- Nursing (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (2)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (3)
- Provider: Nurse (1)
- Quality Improvement (1)
- Quality of Care (1)
- Risk (3)
- Shared Decision Making (1)
- Skin Conditions (1)
- Surgery (3)
- Web-Based (1)
- Women (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 10 of 10 Research Studies DisplayedShi J, Hurdle JF, Johnson SA
Natural language processing for the surveillance of postoperative venous thromboembolism.
The objective of the study was to develop a portal natural language processing approach to aid in the identification of postoperative venous thromboembolism events from free-text clinical notes. The investigators concluded that accurate surveillance of postoperative venous thromboembolism may be achieved using natural language processing on clinical notes in 2 independent health care systems. They indicated that these findings suggest natural language processing may augment manual chart abstraction for large registries such as National Surgical Quality Improvement Program.
AHRQ-funded; HS025776.
Citation: Shi J, Hurdle JF, Johnson SA .
Natural language processing for the surveillance of postoperative venous thromboembolism.
Surgery 2021 Oct;170(4):1175-82. doi: 10.1016/j.surg.2021.04.027..
Keywords: Blood Clots, Health Information Technology (HIT), Quality Improvement, Quality of Care, Surgery, Adverse Events
Vaughn VM, Yost M, Abshire C
Trends in venous thromboembolism anticoagulation in patients hospitalized with COVID-19.
This study’s objective was to characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality. This cohort study used adults hospitalized with COVID-19 from 30 pseudorandom hospitals in Michigan from March 7, 2020, to June 17, 2020. Main outcomes measured were the effect of nonadherence and anticoagulation strategies on in-hospital and 60-day mortality. Of a total 1351 patients with COVID-19 with a median age of 64 years, 47.7% women and 48.9% Black, only 18 (1.3%) had a confirmed VTE, and 219 (16.2%) received treatment-dose anticoagulation. Use of treatment-dose anticoagulation without imaging ranged from 0% to 29% across hospitals and increased over time. Of 1127 patients who ever received anticoagulation, 392 missed 2 or more days of prophylaxis. Missed prophylaxis varied from 11% to 61% across hospitals and decreased markedly over time. VTE nonadherence was associated with higher 60-day (adjusted hazard ratio [aHR], 1.31) but not in-hospital mortality (aHR, 0.97). Receiving any dose of anticoagulation (vs no anticoagulation) was associated with lower in-hospital mortality (only prophylactic dose: aHR, 0.36; any treatment dose: aHR, 0.38). However, only the prophylactic dose of anticoagulation remained associated with lower mortality at 60 days (prophylactic dose: aHR, 0.71; treatment dose: aHR, 0.92).
AHRQ-funded; HS026530.
Citation: Vaughn VM, Yost M, Abshire C .
Trends in venous thromboembolism anticoagulation in patients hospitalized with COVID-19.
JAMA Netw Open 2021 Jun 1; 4(6):e2111788. doi: 10.1001/jamanetworkopen.2021.11788..
Keywords: COVID-19, Blood Clots, Blood Thinners, Medication, Inpatient Care, Cardiovascular Conditions
Shaheen MS, Silverberg JI
Association of inflammatory skin diseases with venous thromboembolism in US adults.
Patients with certain inflammatory skin diseases have multiple risk factors for venous thromboembolism (VTE). The objective of the study was to determine whether atopic dermatitis (AD), psoriasis, pemphigus, pemphigoid and/or hidradenitis was associated with VTE in US adults. Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations.
AHRQ-funded; HS023011.
Citation: Shaheen MS, Silverberg JI .
Association of inflammatory skin diseases with venous thromboembolism in US adults.
Arch Dermatol Res 2021 May;313(4):281-89. doi: 10.1007/s00403-020-02099-6..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Blood Clots, Risk
Iroz CB, Dahl CM, Cassimatis IR
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
The objective of this study was to determine the optimal modality for venous thromboembolism prophylaxis during hospitalization for preterm premature rupture of membranes using a decision analysis model. The investigators concluded that their results did not support the routine use of prophylactic anticoagulation in women admitted to the hospital for preterm premature rupture of membranes.
AHRQ-funded; HS000084.
Citation: Iroz CB, Dahl CM, Cassimatis IR .
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
Am J Obstet Gynecol MFM 2021 May;3(3):100311. doi: 10.1016/j.ajogmf.2021.100311..
Keywords: Blood Clots, Blood Thinners, Prevention, Shared Decision Making, Pregnancy, Maternal Care, Inpatient Care, Women, Medication
Khorfan R, Kreutzer L, Love R
Association between missed doses of chemoprophylaxis and VTE incidence in a statewide colectomy cohort.
The objectives of this study were to assess the incidence of missed doses of inpatient venous thromboembolism (VTE) chemoprophylaxis after colectomy in a statewide patient cohort and to examine the association between missed chemoprophylaxis doses and postoperative VTE. Findings showed that 13% of post-colectomy inpatients did not receive all prescribed doses of inpatient VTE chemoprophylaxis, and at least 1 missed dose of chemoprophylaxis was associated with an over twofold increased incidence of VTE among patients at high risk for VTE. Recommendations included verifying that patients receive all prescribed doses, identifying why doses are missed, and instituting quality improvement efforts to ensure patients receive all appropriate doses.
AHRQ-funded; HS024516.
Citation: Khorfan R, Kreutzer L, Love R .
Association between missed doses of chemoprophylaxis and VTE incidence in a statewide colectomy cohort.
Ann Surg 2021 Apr;273(4):e151-e52. doi: 10.1097/sla.0000000000004349..
Keywords: Blood Clots, Adverse Events, Surgery
Feng Y, Pai CW, Seiler K
Inappropriate prescription of direct oral anticoagulant starter packs.
This study looked at the rates of inappropriate prescription of direct oral anticoagulant starter packs using a retrospective analysis of national outpatient pharmacy claims from 2015 to 2018. Inappropriate prescription is defined as a prescription without a venous thromboembolism diagnosis within the prior 45 days or a prescription with a prior starter pack fill within the past 45 days. A total of 3711 prescriptions were identified, representing 3634 unique patients. Mean patient age was 62.8 years and 50.4% were females. There were 770 (20.7%) prescriptions defined as potentially inappropriate. Patients prescribed inappropriate fills were likely to be slightly older than patients with appropriate fills (64.7 vs 62.4 years). There was no significant difference in race or geographic location among the two groups.
AHRQ-funded; HS026874.
Citation: Feng Y, Pai CW, Seiler K .
Inappropriate prescription of direct oral anticoagulant starter packs.
Am J Med 2021 Mar;134(3):370-73.e1. doi: 10.1016/j.amjmed.2020.06.045..
Keywords: Blood Thinners, Medication, Blood Clots
Schlick CJR, Yuce TK, Yang AD
A postdischarge venous thromboembolism risk calculator for inflammatory bowel disease surgery.
Guidelines recommend extended chemoprophylaxis for venous thromboembolism in high-risk patients having operations for inflammatory bowel disease. Quantifying patients' risk of venous thromboembolism, however, remains challenging. In this study, the investigators sought (1) to identify factors associated with postdischarge venous thromboembolism in patients undergoing colorectal resection for inflammatory bowel disease and (2) to develop a postdischarge venous thromboembolism risk calculator to guide prescribing of extended chemoprophylaxis.
AHRQ-funded; HS024516; HS000078; HS026385.
Citation: Schlick CJR, Yuce TK, Yang AD .
A postdischarge venous thromboembolism risk calculator for inflammatory bowel disease surgery.
Surgery 2021 Feb;169(2):240-47. doi: 10.1016/j.surg.2020.09.006..
Keywords: Blood Clots, Adverse Events, Patient Safety, Surgery, Risk
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Lau BD, Shaffer DL, Hobson DB
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
AHRQ-funded; HS024547.
Citation: Lau BD, Shaffer DL, Hobson DB .
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
PLoS One 2017 Aug 16;12(8):e0181664. doi: 10.1371/journal.pone.0181664.
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Keywords: Blood Clots, Education: Continuing Medical Education, Medication, Nursing, Prevention, Provider: Nurse, Web-Based, Practice Patterns
Jones CE, Hollis RH, Gullick AA
Venous thromboembolic events: how low can you go?
This study evaluated postoperative venous thromboembolism (VTE) chemical prophylaxis adherence to assess the preventability of VTEs. It found that nearly half of patients who experienced postoperative VTEs received appropriate guideline-driven care. Most interruptions in chemical prophylaxis were justified medically. This further questions the preventability of postoperative VTEs and the utility of this outcome as a valid measure of hospital quality.
AHRQ-funded; HS013852.
Citation: Jones CE, Hollis RH, Gullick AA .
Venous thromboembolic events: how low can you go?
Am J Surg 2017 Apr;213(4):706-10. doi: 10.1016/j.amjsurg.2016.10.037.
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Keywords: Adverse Events, Blood Clots, Blood Thinners, Patient-Centered Outcomes Research, Prevention