National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- (-) Adverse Events (23)
- Ambulatory Care and Surgery (1)
- Blood Clots (2)
- Blood Thinners (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (4)
- Children/Adolescents (1)
- Decision Making (1)
- Elderly (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Heart Disease and Health (1)
- Hepatitis (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Injuries and Wounds (6)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Medication (3)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (10)
- Pregnancy (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Registries (1)
- Respiratory Conditions (1)
- (-) Risk (23)
- Rural Health (1)
- Surgery (12)
- Transplantation (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 23 of 23 Research Studies DisplayedRajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
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
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
Kurtz MP, McNamara ER, Schaeffer AJ
Association of BMI and pediatric urologic postoperative events: results from pediatric NSQIP.
The researchers sought to determine the association of elevated BMI with overall 30-day postoperative events and wound complications in a large national sample of children undergoing urologic procedures. They concluded that BMI in the pediatric National Surgical Quality Improvement Program urologic population was found to be associated with overall complication after adjustment for case type and preoperative comorbidity.
AHRQ-funded; HS000063.
Citation: Kurtz MP, McNamara ER, Schaeffer AJ .
Association of BMI and pediatric urologic postoperative events: results from pediatric NSQIP.
J Pediatr Urol 2015 Aug;11(4):224.e1-6. doi: 10.1016/j.jpurol.2015.04.014..
Keywords: Surgery, Children/Adolescents, Obesity, Risk, Adverse Events
Tsilimingras D, Schnipper J, Duke A
Post-discharge adverse events among urban and rural patients of an urban community hospital: a prospective cohort study.
The researchers aimed to determine the rate of postdischarge adverse events (AEs), classify the types of post-discharge AEs, and identify risk factors for post-discharge AEs in urban and rural patients. They found that post-discharge AEs were common in both urban and rural patients and many were preventable or ameliorable.
AHRQ-funded; HS018694.
Citation: Tsilimingras D, Schnipper J, Duke A .
Post-discharge adverse events among urban and rural patients of an urban community hospital: a prospective cohort study.
J Gen Intern Med 2015 Aug;30(8):1164-71. doi: 10.1007/s11606-015-3260-3..
Keywords: Adverse Events, Hospital Discharge, Outcomes, Risk, Rural Health
Shah UH, Mandl LA, Mertelsmann-Voss C
Systemic lupus erythematosus is not a risk factor for poor outcomes after total hip and total knee arthroplasty.
The researchers sought to determine if systemic lupus erythematosus (SLE) remains an independent risk factor for poor arthroplasty outcomes or if other factors, such as avascular necrosis , continue to play a role. They found that SLE was not an independent risk factor for poor short-term pain or function after either hip or knee arthroplasty.
AHRQ-funded; HS016075.
Citation: Shah UH, Mandl LA, Mertelsmann-Voss C .
Systemic lupus erythematosus is not a risk factor for poor outcomes after total hip and total knee arthroplasty.
Lupus 2015 Aug;24(9):900-8. doi: 10.1177/0961203314566635.
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Keywords: Surgery, Risk, Outcomes, Adverse Events
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL
Maternal age and risk of labor and delivery complications.
The researchers examined associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Using HCUP data, they found that complications with the highest odds among women 11-18 years of age included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women 35 and older had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Women over 40 had increased odds for mild preeclampsia, fetal distress, and poor fetal growth.
AHRQ-funded; HS019455.
Citation: Cavazos-Rehg PA, Krauss MJ, Spitznagel EL .
Maternal age and risk of labor and delivery complications.
Matern Child Health J 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
Sharma G, Meena R, Goodwin JS
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
The researchers quantified the risk of burn injury associated with home oxygen use and examined the risk factors associated with the development of this injury. They found that the absolute risk of burn injury in patients prescribed oxygen therapy was 2.98 per 1000 patients compared with 1.69 per 1000 patients not prescribed oxygen during a 22-month period.
AHRQ-funded; HS020642; HS022134.
Citation: Sharma G, Meena R, Goodwin JS .
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
Mayo Clin Proc 2015 Apr;90(4):492-9. doi: 10.1016/j.mayocp.2014.12.024..
Keywords: Injuries and Wounds, Adverse Events, Risk, Respiratory Conditions, Elderly
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
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
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
Holcomb CN, Graham LA, Richman JS
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
The investigators sought to determine the incremental risk of noncardiac surgery on myocardial infarction (MI) and coronary revascularization following coronary stenting. They found that the incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
J Am Coll Cardiol 2014 Dec 30;64(25):2730-9. doi: 10.1016/j.jacc.2014.09.072.
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Keywords: Adverse Events, Cardiovascular Conditions, Patient-Centered Healthcare, Risk, Surgery
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
Safford MM, Barasch A, Curtis JR
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
This study examined associations between bisphosphonate use and nontraumatic subtrochanteric (NTST) femoral fractures and hip fractures in the Veterans Health Administration. It found that nontraumatic subtrochanteric femoral fractures were uncommon, and longer bisphosphonate use was associated with lower (not higher) risk. In men, risks of NTST femoral fractures associated with bisphosphonate treatment may be low in contrast to substantial protective benefits for hip fracture.
AHRQ-funded; HS016956; HS018517.
Citation: Safford MM, Barasch A, Curtis JR .
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
J Clin Rheumatol 2014 Oct;20(7):357-62. doi: 10.1097/rhu.0000000000000170..
Keywords: Elderly, Injuries and Wounds, Risk, Medication, Adverse Events
Majid A, McAninch J, Morgan DJ
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
This study aimed to assess early treatment discontinuation rates and identify underlying risk factors for discontinuation in a real-world boceprevir-based treatment cohort. Nearly half of patients started on boceprevir-based hepatitis C triple therapy stopped treatment by 24 weeks, with more discontinuing because of treatment intolerance than virologic failure. Early discontinuation was significantly more common in patients with comorbidities.
AHRQ-funded; HS018111.
Citation: Majid A, McAninch J, Morgan DJ .
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
J Viral Hepat 2014 Aug;21(8):585-9. doi: 10.1111/jvh.12201.
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Keywords: Hepatitis, Adverse Events, Medication, Risk
Dahlke AR, Merkow RP, Chung JW
Comparison of postoperative complication risk prediction approaches based on factors known preoperatively to surgeons versus patients.
The objective of this paper was to compare three estimation models: (1) the All Information Model; (2) the Surgeon Assessment Model; and (3) the Patient-Entered Model. The investigators observed a small decline in model performance that they suggest may not be clinically meaningful. They concluded that the Surgeon Assessment and Patient-Entered models with fewer predictors can be used with relative confidence to predict a patient's risk.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Merkow RP, Chung JW .
Comparison of postoperative complication risk prediction approaches based on factors known preoperatively to surgeons versus patients.
Surgery 2014 Jul;156(1):39-45. doi: 10.1016/j.surg.2014.03.002.
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Keywords: Adverse Events, Decision Making, Risk, Surgery
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
Arkin N, Lee PH, McDonald K
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
The purpose of this study was to examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. The investigators found that the hospital volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. They identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes.
AHRQ-funded; HS018558.
Citation: Arkin N, Lee PH, McDonald K .
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
J Card Surg 2014 Mar;29(2):141-8. doi: 10.1111/jocs.12284..
Keywords: Adverse Events, Cardiovascular Conditions, Quality of Care, Mortality, Risk