National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (10)
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Blood Clots (3)
- Blood Thinners (1)
- Cancer (1)
- Cancer: Breast Cancer (2)
- Cardiovascular Conditions (2)
- Care Management (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Elderly (1)
- Falls (2)
- Healthcare-Associated Infections (HAIs) (6)
- Heart Disease and Health (3)
- Hospitalization (1)
- Hospitals (1)
- Injuries and Wounds (3)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Medical Errors (1)
- Medical Liability (1)
- Medication (4)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Patient-Centered Outcomes Research (1)
- (-) Patient Safety (23)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- (-) Risk (23)
- Sleep Problems (1)
- Surgery (7)
- 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 23 of 23 Research Studies DisplayedHignett S, Wolf L, Taylor E
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). : Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management.
AHRQ-funded; HS021824.
Citation: Hignett S, Wolf L, Taylor E .
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
Hum Factors 2015 Nov;57(7):1195-207. doi: 10.1177/0018720815593642.
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Keywords: Patient Safety, Risk, Falls, Hospitals
Ellis MC, Paugh TA, Dickinson TA
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Recent literature has suggested that women, although more often exposed to lower nadir hematocrit (Hct), have a lower risk of postoperative renal dysfunction. The researchers assessed whether this relationship held across a large multicenter registry. They found that lower nadir Hct was associated with an increased risk of AKI, and the effect appears to be stronger among men than women.
AHRQ-funded; HS022535; HS022909.
Citation: Ellis MC, Paugh TA, Dickinson TA .
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Ann Thorac Surg 2015 Nov;100(5):1549-54; discussion 54-5. doi: 10.1016/j.athoracsur.2015.05.080..
Keywords: Risk, Cardiovascular Conditions, Surgery, Adverse Events, Patient Safety
Alruwaily AF, Eisner BH, Bierlein MJ
Statin use and risk of sepsis after percutaneous nephrolithotomy.
The researchers examined the association between statin medication use and sepsis risk after percutaneous nephrolithotomy (PCNL). They found that statin use is not associated with reductions in postoperative sepsis, nonfebrile urinary tract infections, ICU utilization, or hospital length of stay after PCNL.
AHRQ-funded; HS020927.
Citation: Alruwaily AF, Eisner BH, Bierlein MJ .
Statin use and risk of sepsis after percutaneous nephrolithotomy.
J Endourol 2015 Oct;29(10):1126-30. doi: 10.1089/end.2015.0042..
Keywords: Medication, Risk, Surgery, Adverse Events, Patient Safety
Valley TS, Cooke CR
The epidemiology of sepsis: questioning our understanding of the role of race.
Black individuals have been demonstrated to be nearly twice as likely to develop sepsis. However, in a recent study involving a cohort of stroke patients, investigators determined that black participants were significantly less likely than white participants to present to the hospital with either infection or sepsis. Although these results are intriguing, they highlight the inadequate understanding of the relationship between race and sepsis.
AHRQ-funded; HS020672.
Citation: Valley TS, Cooke CR .
The epidemiology of sepsis: questioning our understanding of the role of race.
Crit Care 2015 Oct 1;19:347. doi: 10.1186/s13054-015-1074-7..
Keywords: Racial and Ethnic Minorities, Patient Safety, Risk
Greene MT, Flanders SA, Woller SC
The association between PICC use and venous thromboembolism in upper and lower extremities.
The researchers examined the risk of venous thromboembolism in deep veins of the arm, leg, and chest after peripherally inserted central catheter placement (PICC). They found that PICC use is associated with upper- and lower-extremity deep vein thrombosis.
AHRQ-funded; HS022835.
Citation: Greene MT, Flanders SA, Woller SC .
The association between PICC use and venous thromboembolism in upper and lower extremities.
Am J Med 2015 Sep;128(9):986-93.e1. doi: 10.1016/j.amjmed.2015.03.028..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords: Sleep Problems, Surgery, Patient Safety, Risk, Heart Disease and Health, Respiratory Conditions, Chronic Conditions
Curtis JR, Xie F, Yun H
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
The researchers evaluated rates of hospitalized infection among patients treated with biologic agents for RA who subsequently initiated denosumab in order to assess whether rates of infection were increased with concurrent biologic agent use for RA. They found that the rate of hospitalized infection among RA patients receiving denosumab concurrently with biologic agents for RA was not increased compared to those receiving zoledronate.
AHRQ-funded; HS018517
Citation: Curtis JR, Xie F, Yun H .
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
Arthritis Rheumatol. 2015 Jun;67(6):1456-64. doi: 10.1002/art.39075..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Risk, Patient Safety, Comparative Effectiveness
Chopra V, Fallouh N, McGuirk H
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
The purpose of this study was to determine patterns, risk factors and treatment related to peripherally inserted central catheters-deep vein thrombosis (PICC-DVT) in hospitalized patients. It found that treatment for PICC-DVT varied and included heparin bridging, low molecular weight heparin only and device removal only; the average duration of treatment also varied across these groups.
AHRQ-funded; HS022835.
Citation: Chopra V, Fallouh N, McGuirk H .
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
Thromb Res 2015 May;135(5):829-34. doi: 10.1016/j.thromres.2015.02.012..
Keywords: Patient Safety, Blood Clots, Blood Thinners, Risk, Hospitalization
Yun H, Xie F, Delzell E
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
This study evaluated whether the risks of herpes zoster (HZ) differed by biologic agents with different mechanisms of action (MOAs) in older rheumatoid arthritis (RA) patients. Using Medicare data from 2006–2011, the researchers found that among RA patients, the rate and adjusted hazard ratios of HZ were similar among biologic agents, including those with non–tumor necrosis factor mechanisms of action.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
Arthritis Care Res 2015 May;67(5):731-6. doi: 10.1002/acr.22470..
Keywords: Arthritis, Risk, Patient Safety, Patient-Centered Outcomes Research
Nykiel-Bailey SM, McAllister JD, Schrock CR
Difficult airway consultation service for children: steps to implement and preliminary results.
The article demonstrates how to implement a consultative service focusing on difficult airway (DAW) identification, management and education. The initial 3-month experience confirmed that a majority of pediatric DAW events are associated with congenital or acquired abnormalities. Through appropriate consultation and leadership, the Difficult Airway Service was able to physically and electronically identify pediatric patients with a DAW and provide management.
AHRQ-funded; HS022265.
Citation: Nykiel-Bailey SM, McAllister JD, Schrock CR .
Difficult airway consultation service for children: steps to implement and preliminary results.
Paediatr Anaesth 2015 Apr;25(4):363-71. doi: 10.1111/pan.12625..
Keywords: Care Management, Children/Adolescents, Respiratory Conditions, Patient Safety, Risk
Pepin CS, Thom KA, Sorkin JD
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
This cohort study explored risk factors for CLABSI using 2 comorbidity classification schemes, the Charlson Comorbidity Index (CCI) and the Chronic Disease Score (CDS). It found that individual comorbid conditions obtained electronically by ICD-9 codes and admission medications can be used to identify factors for increased risk for CLABSI. The composite CDS and CCI scores were not risk factors.
AHRQ-funded; HS022291.
Citation: Pepin CS, Thom KA, Sorkin JD .
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
Infect Control Hosp Epidemiol 2015 Apr;36(4):479-81. doi: 10.1017/ice.2014.81..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Brooks JM, Cook E, Chapman CG
Statin use after acute myocardial infarction by patient complexity: are the rates right?
The researchers assessed the benefits and risks associated with higher rates of statin use after AMI by baseline patient complexity. Their results provide strong evidence that providers were attempting to individualize statin prescribing to patients after AMI. Statin users after AMI were less complex and had higher rates of prior statin use.
AHRQ-funded; HS019574.
Citation: Brooks JM, Cook E, Chapman CG .
Statin use after acute myocardial infarction by patient complexity: are the rates right?
Med Care 2015 Apr;53(4):324-31. doi: 10.1097/mlr.0000000000000322..
Keywords: Patient Safety, Risk, Cardiovascular Conditions, Heart Disease and Health, Medication
Olsen MA, Nickel KB, Wallace AE
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
The researchers investigated whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. After analyzing a total of 119,973 hernia repair procedures, they found that the incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction necrosis.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Wallace AE .
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
Infect Control Hosp Epidemiol 2015 Mar;36(3):329-35. doi: 10.1017/ice.2014.44..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk, Patient Safety
Kozminski MA, Kozminski DJ, Roberts WW
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
The researchers sought to document the rate of and risk factors for the rare complication of symptomatic renal hematoma following ureteroscopic lithotripsy (URSL) for renal calculi. They found that, while symptomatic hematoma is a complication of URSL, the rate of such outcome (0.8 percent) is far less than that reported by prior series with extracorporeal shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL).
AHRQ-funded; HS020927.
Citation: Kozminski MA, Kozminski DJ, Roberts WW .
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
J Endourol 2015 Mar;29(3):277-82. doi: 10.1089/end.2014.0176..
Keywords: Kidney Disease and Health, Patient Safety, Risk, Adverse Events
Sarpatwari A, Franklin JM, Avorn J
Are risk evaluation and mitigation strategies associated with less off-label use of medications? The case of immune thrombocytopenia.
Using data from a large commercial health insurer, the researchers studied prescribing of two drugs for primary immune thrombocytopenia for which risk evaluation and mitigation strategies (REMS) with elements to assure safe use were initially imposed and then removed. Their finding of an association with reduced off-label prescribing suggests that REMS with elements to assure safe use can help promote patient safety but may also prevent promising off-label drug uses.
AHRQ-funded; HS018465.
Citation: Sarpatwari A, Franklin JM, Avorn J .
Are risk evaluation and mitigation strategies associated with less off-label use of medications? The case of immune thrombocytopenia.
Clin Pharmacol Ther 2015 Feb;97(2):186-93. doi: 10.1002/cpt.17..
Keywords: Medication, Risk, Patient Safety
Stone E, Skubic M, Rantz M
Average in-home gait speed: investigation of a new metric for mobility and fall risk assessment of elders.
This study assessed how a new metric, average in-home gait speed (AIGS), measured using a low-cost, continuous, environmentally mounted monitoring system, compares to a set of traditional physical performance instruments used for mobility and fall risk assessment of elderly adults. It found that, using the ability of an instrument to predict how an individual would score on all the instruments as a metric, AIGS performs best, having better predictive ability than the traditional instruments.
AHRQ-funded; HS018477.
Citation: Stone E, Skubic M, Rantz M .
Average in-home gait speed: investigation of a new metric for mobility and fall risk assessment of elders.
Gait Posture 2015 Jan;41(1):57-62. doi: 10.1016/j.gaitpost.2014.08.019..
Keywords: Patient Safety, Falls, Elderly, Risk
Santos P, Ritter GA, Hefele JL
Decreasing intrapartum malpractice: targeting the most injurious neonatal adverse events.
The researchers conducted a case study of a risk reduction labor and delivery model at 5 demonstration sites. After 27 months post implementation, reporting of unintended events increased significantly (43 vs 84 per 1000 births), while high-risk malpractice events decreased significantly (14 vs 7 per 1000 births).
AHRQ-funded; HS019608.
Citation: Santos P, Ritter GA, Hefele JL .
Decreasing intrapartum malpractice: targeting the most injurious neonatal adverse events.
J Healthc Risk Manag 2015;34(4):20-7. doi: 10.1002/jhrm.21168..
Keywords: Labor and Delivery, Patient Safety, Risk, Medical Liability, Medical Errors
Foglia EE, Ades A, Napolitano N
Factors associated with adverse events during tracheal intubation in the NICU.
This study sought to determine the incidence of adverse tracheal intubation-associated events (TIAEs and to identify factors associated with TIAEs in the NICU. It found that adverse TIAEs occurred in 153 of 701 (22 percent) tracheal intubation encounters. Modifiable risk factors associated with TIAEs identified include intubator training level and use of paralytic medications.
AHRQ-funded; HS021583.
Citation: Foglia EE, Ades A, Napolitano N .
Factors associated with adverse events during tracheal intubation in the NICU.
Neonatology 2015;108(1):23-9. doi: 10.1159/000381252..
Keywords: Patient Safety, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk, Adverse Events
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Segal CG, Waller DK, Tilley B
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
The authors developed four independent, multivariate, predictive models to assess the unique associations between risk factors and each surgical site infection (SSI) group: superficial, deep, organ space, and an aggregate of all 3 types of SSIs. They found that unique risks for superficial SSIs include diabetes, chronic obstructive pulmonary disease, and dyspnea; deep SSIs had the greatest magnitude of association with BMI and the greatest incidence of wound disruption; and organ space SSIs were often owing to anastomotic leaks and were uniquely associated with disseminated cancer, preoperative dialysis, preoperative radiation treatment, and a bleeding disorder. They concluded that more effective prevention strategies may be developed by reporting and examining each type of SSI separately.
AHRQ-funded; HS021857.
Citation: Segal CG, Waller DK, Tilley B .
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
Surgery 2014 Nov;156(5):1253-60. doi: 10.1016/j.surg.2014.05.010.
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Keywords: Risk, Healthcare-Associated Infections (HAIs), Adverse Events, Surgery, Patient Safety
Bish EK, El-Amine H, Steighner LA
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
The researchers sought to identify the risk factors associated with surgical site infections (SSIs) resulting from procedures performed at ambulatory surgery centers (ASCs) and to design an intervention to mitigate the likelihood of SSIs for the most common risk factors that were identified by the socio-technical probabilistic risk assessment (ST-PRA) tool for a particular surgical procedure. They found that failure to protect the patient effectively accounted for 51.9% of SSIs in the ambulatory care setting. Critical components of this event included skin preparation, antibiotic administration, staff training, proper response to glove punctures during surgery, and adherence to surgical preparation rules related to the wearing of jewelry, watches, and artificial nails. They determined that, assuming a 75% reduction in noncompliance on any combination of 2 of these 5 components, the risk for an SSI decreased.
AHRQ-funded; 290200600019I.
Citation: Bish EK, El-Amine H, Steighner LA .
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S133-41. doi: 10.1086/677824.
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Keywords: Ambulatory Care and Surgery, Risk, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Ezaz G, Long JB, Gross CP
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
The investigators sought to develop a clinical risk score that identifies older women with breast cancer who are at higher risk of heart failure or cardiomyopathy after trastuzumab. That found that a 7-factor risk score was able to stratify 3-year risk of heart failure/cardiomyopathy after trastuzumab between the lowest and highest risk groups by more than 2-fold in a Medicare population.
AHRQ-funded; HS018781.
Citation: Ezaz G, Long JB, Gross CP .
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
J Am Heart Assoc 2014 Feb;3(1):e000472. doi: 10.1161/jaha.113.000472.
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Keywords: Cancer: Breast Cancer, Heart Disease and Health, Medication, Patient Safety, Risk