National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (3)
- Behavioral Health (1)
- Cardiovascular Conditions (4)
- Children/Adolescents (1)
- Community-Acquired Infections (1)
- Depression (1)
- Elderly (7)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Falls (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
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- Heart Disease and Health (3)
- Home Healthcare (2)
- Hospital Discharge (1)
- (-) Hospitalization (14)
- Hospitals (1)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Long-Term Care (1)
- Medicare (2)
- Medication (3)
- Mortality (5)
- Nursing (1)
- Nursing Homes (1)
- Opioids (1)
- Patient Safety (1)
- Pregnancy (1)
- Public Health (1)
- Rehabilitation (1)
- (-) Risk (14)
- Sepsis (1)
- Surgery (2)
- Transitions of Care (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 14 of 14 Research Studies DisplayedGuglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Topaz M, Woo K, Ryvicker M
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
About 30% of home healthcare patients are hospitalized or visit an emergency department (ED) during a home healthcare (HHC) episode. Novel data science methods are increasingly used to improve identification of patients at risk for negative outcomes. The aim of the study was to identify patients at heightened risk hospitalization or ED visits using HHC narrative data (clinical notes).
AHRQ-funded; HS027742.
Citation: Topaz M, Woo K, Ryvicker M .
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
Nurs Res 2020 Nov/Dec;69(6):448-54. doi: 10.1097/nnr.0000000000000470..
Keywords: Elderly, Home Healthcare, Emergency Department, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wu SS, Bellantoni m, Weiner JP
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
The purpose of this study was to assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. The investigators found that geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts.
AHRQ-funded; HS000029.
Citation: Wu SS, Bellantoni m, Weiner JP .
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
Am J Manag Care 2020 Oct;26(10):e319-e26. doi: 10.37765/ajmc.2020.88505..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Risk, Healthcare Utilization, Hospitalization
Wehbe RM, Khan SS, Shah SJ
Predicting high-risk patients and high-risk outcomes in heart failure.
Identifying patients with heart failure at high risk for poor outcomes is important for patient care, resource allocation, and process improvement. Although numerous risk models exist to predict mortality, hospitalization, and patient-reported health status, they are infrequently used for several reasons, including modest performance, lack of evidence to support routine clinical use, and barriers to implementation. The authors discuss the potential of artificial to enhance the performance of risk prediction models.
AHRQ-funded; HS026385.
Citation: Wehbe RM, Khan SS, Shah SJ .
Predicting high-risk patients and high-risk outcomes in heart failure.
Heart Fail Clin 2020 Oct;16(4):387-407. doi: 10.1016/j.hfc.2020.05.002..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Hospitalization
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
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
Basciotta M, Zhou W, Ngo L
Antipsychotics and the risk of mortality or cardiopulmonary arrest in hospitalized adults.
Investigators sought to evaluate the risk of death or nonfatal cardiopulmonary arrest in hospitalized adults exposed to antipsychotics. They found that, in hospitalized adults, typical antipsychotics were associated with increased mortality or cardiopulmonary arrest, whereas atypical antipsychotics were only associated with increased risk among adults age 65 years and older. They recommended that providers be thoughtful when prescribing antipsychotic medications, especially to older adults in settings where data regarding benefit are lacking.
AHRQ-funded; HS026215.
Citation: Basciotta M, Zhou W, Ngo L .
Antipsychotics and the risk of mortality or cardiopulmonary arrest in hospitalized adults.
J Am Geriatr Soc 2020 Mar;68(3):544-50. doi: 10.1111/jgs.16246..
Keywords: Medication, Risk, Hospitalization, Cardiovascular Conditions, Mortality, Elderly
Herzig SJ, Stefan MS, Pekow PS
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
The objective of this study was to identify independent risk factors for severe opioid-related adverse drug events (ORADEs) in hospitalized patients. This retrospective cohort study used data from medical patients hospitalized at US non-federal and acute care facilities with at least one pharmacy charge. They excluded patients with metastatic, hospice, or palliative care billing codes. Out of 731,208 hospitalizations there was a severe ORADE in 2727 (0.4%) of patients. Independent risk factors included advanced age, female gender, comorbidities, organ failures on admission, medication co-administrations, and characteristics of the opioids themselves. These risk factors can be used to inform physician decision-making and conversations with patients about risk.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Stefan MS, Pekow PS .
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
J Gen Intern Med 2020 Feb;35(2):538-45. doi: 10.1007/s11606-019-05490-w..
Keywords: Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Hospitalization
Angraal S, Mortazavi BJ, Gupta A
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
This study developed models to predict the risk of death and hospitalization in patients with heart failure (HF) with preserved ejection fraction (HFpEF). Data was used from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) clinical trial. Five methods: logistic regression with a forward selection of variables; logistic regression with a lasso regularization for variable selection; random forest (RF); gradient descent boosting; and support vector machine, were used to train models for assessing risks of mortality and HF hospitalization through 3 years of follow-up and were validated using 5-fold cross-validation. RF was found to be the best performing model for predicting mortality and HF hospitalization. Blood urea nitrogen levels, body mass index, and Kansas City Cardiomyopathy Questionnaire (KCCQ) subscale scores were strongly associated with mortality, while hemoglobin level, blood urea nitrogen, time since previous HF hospitalization, and KCCQ scores were the most significant predictors of HF hospitalization.
AHRQ-funded; HS023000.
Citation: Angraal S, Mortazavi BJ, Gupta A .
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
JACC Heart Fail 2020 Jan;8(1):12-21. doi: 10.1016/j.jchf.2019.06.013..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Mortality, Hospitalization, Risk, Health Status, Health Information Technology (HIT)
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
Liu J, Larson E, Hessels A
Comparison of measures to predict mortality and length of stay in hospitalized patients.
This study compared performance of five measures in order to predict mortality and length of stay (LOS) in hospitalized adults using claims data; the measures included three comorbidity composite scores, 3 M risk of mortality, and 3 M severity of illness subclasses. Binary logistic and zero-truncated negative binomial regression models were applied to a 2-year retrospective dataset of adult inpatient admissions from a large hospital system in New York City. All five measures demonstrated a good to strong model fit for predicting in-hospital mortality. The authors conclude that these measures can guide nurse managers in assigning nursing care and coordinating patient services, as well as administrators in supporting optimal nursing care more effectively and efficiently.
AHRQ-funded; HS024915.
Citation: Liu J, Larson E, Hessels A .
Comparison of measures to predict mortality and length of stay in hospitalized patients.
Nurs Res 2019 May/Jun;68(3):200-09. doi: 10.1097/nnr.0000000000000350..
Keywords: Hospitalization, Mortality, Nursing, Patient Safety, Risk
Vaidyanathan A, Saha S, Vicedo-Cabrera AM
AHRQ Author: Elixhauser A
Assessment of extreme heat and hospitalizations to inform early warning systems.
The purpose of this study was to conduct multistate analyses to explore associations between heat and all-cause and cause-specific hospitalizations, in order to inform the design and development of heat-health early warning systems. Researchers used a two-stage analysis to estimate heat-health risk relationships between heat index and hospitalizations, then used the results to identify heat index ranges that corresponded with a significant heat-attributable burden and compared these to National Weather Service (NWS) heat alert criteria used during the same time period. The study’s conclusions suggest that locally specific health evidence can inform and calibrate heat alert criteria.
AHRQ-authored.
Citation: Vaidyanathan A, Saha S, Vicedo-Cabrera AM .
Assessment of extreme heat and hospitalizations to inform early warning systems.
Proc Natl Acad Sci U S A 2019 Mar 19;116(12):5420-27. doi: 10.1073/pnas.1806393116..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Public Health, Risk