National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (6)
- Blood Thinners (1)
- Cardiovascular Conditions (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
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- Healthcare Cost and Utilization Project (HCUP) (2)
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- (-) Kidney Disease and Health (9)
- Medication (3)
- Medication: Safety (3)
- Mortality (2)
- Organizational Change (1)
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- Patient-Centered Outcomes Research (1)
- (-) Patient Safety (9)
- Provider (1)
- Registries (2)
- Surgery (1)
- Surveys on Patient Safety Culture (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 9 of 9 Research Studies DisplayedYao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kurani S, Jeffery MM, Thorsteinsdottir B
Use of potentially nephrotoxic medications by U.S. adults with chronic kidney disease: NHANES, 2011-2016.
This study looked at the prevalence of potentially inappropriate medication (PIM) use by US adults by chronic kidney disease (CKD) stage and self-reported CKD awareness. A cross-sectional analysis of National Health and Nutrition Examination Surveys, 2011-2016 was conducted using a cohort of non-pregnant CKD adults with stages 3a, 3b, or 4-5 CKD. Analyses were adjusted for sex, age, race/ethnicity, education, comorbidities, and insurance type. More than 50% of US adults were taking PIM(s) for all CKD stages and awareness categories, but rates were highest among CKD-unaware patients with stages 4-5 CKD. Proton pump inhibitors, opioids, metformin, sulfonylureas, and NSAIDS were used frequently in all CKD stages. NSAIDS were used less frequently when the patient was CKD-aware.
AHRQ-funded; HS025164; HS025402; HS025517.
Citation: Kurani S, Jeffery MM, Thorsteinsdottir B .
Use of potentially nephrotoxic medications by U.S. adults with chronic kidney disease: NHANES, 2011-2016.
J Gen Intern Med 2020 Apr;35(4):1092-101. doi: 10.1007/s11606-019-05557-8..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Chronic Conditions, Patient Safety
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Flory JH, Hennessy S, Bailey CJ
Reports of lactic acidosis attributed to metformin, 2015-2018.
This study examined the effects of allowing patients with mild-moderate chronic kidney disease to use metformin. The researchers examined rates of reports of metformin-associated lactic acidosis (MALA) to FDA’s Adverse Event Reporting System (FAERS). Publicly available data from 2015 to 2018 was analyzed. Reports from the US increased from 111 in 2015 to 243 in 2018. However due to a lack of a denominator or control group they could not conclude US MALA rates have increased. The authors also concluded that while the increased reports deserve attention, further study is needed.
AHRQ-funded; HS023898.
Citation: Flory JH, Hennessy S, Bailey CJ .
Reports of lactic acidosis attributed to metformin, 2015-2018.
Diabetes Care 2020 Jan;43(1):244-46. doi: 10.2337/dc19-0923.
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Keywords: Kidney Disease and Health, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events
Clark-Cutaia MN, Jarrin OF, Thomas-Hawkins C
The perfect storm: stakeholder perspectives on factors contributing to hospital admissions for patients undergoing maintenance hemodialysis.
This study examined reasons why end stage renal disease (ESRD) patients undergoing hemodialysis experience frequent complications and hospitalizations. Interviews and focus groups were conducted with 21 patients living with ESRD, 10 caregivers, and three focus groups with health care professionals. There were four main themes that came out of the discussions: graft site/catheter/access issues, low resistance, breathing problems, and “The perfect storm”. The goal of these interviews were to promote more research to improve transitional care and care delivery for hemodialysis patients.
AHRQ-funded; HS022406.
Citation: Clark-Cutaia MN, Jarrin OF, Thomas-Hawkins C .
The perfect storm: stakeholder perspectives on factors contributing to hospital admissions for patients undergoing maintenance hemodialysis.
Nephrol Nurs J 2020 Jan-Feb;47(1):11-20..
Keywords: Kidney Disease and Health, Dialysis, Adverse Events, Hospitalization, Patient Safety
Brown JR, Rezaee ME, Hisey WM
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
The researchers describe the epidemiology of dialysis-requiring acute kidney injury (AKI-D) as well as associated in-hospital mortality in the US. They found that the incidence rate of AKI-D has increased considerably in the US since 2001. However, in-hospital mortality associated with AKI-D hospital admissions has decreased significantly. AHRQ-funded; HS018443.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Hisey WM .
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
Am J Nephrol 2016;43(4):261-70. doi: 10.1159/000445846.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Kidney Disease and Health
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
Davis KK, Harris KG, Mahishi V
Perceptions of culture of safety in hemodialysis centers.
Staff members, physicians, nurse practitioners, and physician assistants from a sample of hemodialysis facilities completed a 10-item assessment with modified questions from the Hospital Survey on Patient Safety Culture, with an emphasis on safety culture related to vascular access infections. Overall, scores were high, indicating a positive patient safety culture.
AHRQ-funded; 2902010000251.
Citation: Davis KK, Harris KG, Mahishi V .
Perceptions of culture of safety in hemodialysis centers.
Nephrol Nurs J 2016 Mar-Apr;43(2):119-26, 82; quiz 27.
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Keywords: Surveys on Patient Safety Culture, Patient Safety, Dialysis, Kidney Disease and Health, Organizational Change, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Provider
Scialla JJ, Liu J, Crews DC
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
The estimated glomerular filtration rate (eGFR) at dialysis initiation has been rising. This study described geographic variation in estimated glomerular filtration rate (eGFR) at dialysis initiation and determine its association with mortality. It found no associated harm or benefit with early dialysis initiation in the United States.
AHRQ-funded; 290200500341I.
Citation: Scialla JJ, Liu J, Crews DC .
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
Kidney Int 2014 Oct;86(4):798-809. doi: 10.1038/ki.2014.110..
Keywords: Kidney Disease and Health, Outcomes, Patient Safety, Registries