National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Data (1)
- Diagnostic Safety and Quality (4)
- Digestive Disease and Health (1)
- Disparities (2)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Hospitalization (4)
- Hospitals (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (1)
- Low-Income (1)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (3)
- Nursing (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (2)
- (-) Sepsis (11)
- Social Determinants of Health (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 11 of 11 Research Studies DisplayedJones JM, Fingar KR, Miller MA
AHRQ Author: Miller MA; Heslin KC
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in in-hospital sepsis mortality rates by race/ethnicity. Mortality rates adjusted for patient characteristics were higher for all minority groups than for white patients. After adjusting for hospital characteristics, sepsis mortality rates in 2013 were similar for white, black, and Hispanic patients.
AHRQ-authored.
Citation: Jones JM, Fingar KR, Miller MA .
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
Crit Care Med 2017 Dec;45(12):e1209-e17. doi: 10.1097/ccm.0000000000002699.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities, Sepsis
Rhee C, Dantes R, Epstein L
Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014.
The researchers estimated the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. In clinical data from 409 hospitals, sepsis was present in 6 percent of adult hospitalizations, and in contrast to claims-based analyses, neither the incidence of sepsis nor the combined outcome of death or discharge to hospice changed significantly between 2009-2014.
AHRQ-funded; HS025008.
Citation: Rhee C, Dantes R, Epstein L .
Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014.
JAMA 2017 Oct 3;318(13):1241-49. doi: 10.1001/jama.2017.13836.
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Keywords: Data, Electronic Health Records (EHRs), Hospitals, Mortality, Sepsis
Xavier Moore J, Donnelly JP, Griffin R
Community characteristics and regional variations in sepsis.
This study aimed to determine the influence of community characteristics upon regional variations in sepsis incidence and case fatality. The study concluded that regional variations in sepsis incidence may be partly explained by community poverty. Other community characteristics do not explain regional variations in sepsis incidence or case fatality.
AHRQ-funded; HS013852.
Citation: Xavier Moore J, Donnelly JP, Griffin R .
Community characteristics and regional variations in sepsis.
Int J Epidemiol 2017 Oct 1;46(5):1607-17. doi: 10.1093/ije/dyx099..
Keywords: Disparities, Low-Income, Mortality, Sepsis, Social Determinants of Health
Chaudhary NS, Donnelly JP, Moore JX
Association of baseline steroid use with long-term rates of infection and sepsis in the REGARDS cohort.
Prior studies associate steroid use with infection risk but were limited to select populations and short follow-up periods. This population-based cohort study sought to determine the association of steroid risk with long-term risks of community- acquired infections and sepsis. It concluded that baseline steroid use was associated with increased long-term risks of community-acquired infections and sepsis.
AHRQ-funded; HS013852.
Citation: Chaudhary NS, Donnelly JP, Moore JX .
Association of baseline steroid use with long-term rates of infection and sepsis in the REGARDS cohort.
Crit Care 2017 Jul 13;21(1):185. doi: 10.1186/s13054-017-1767-1.
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Keywords: Healthcare-Associated Infections (HAIs), Medication, Sepsis, Risk
Donnelly JP, Safford MM, Shapiro NI
Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study.
The Consensus Definitions present clinical criteria for the classification of patients with sepsis. Researchers investigated incidence and long-term outcomes of patients diagnosed with these classifications, which are currently unknown. Their findings support the use of the elevated sepsis-related organ failure assessment (SOFA) score from Sepsis-3, and elevated quick SOFA (qSOFA) score from Sepsis-3 classifications to identify patients with infection who are at elevated risk of poor outcomes.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Safford MM, Shapiro NI .
Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study.
Lancet Infect Dis 2017 Jun;17(6):661-70. doi: 10.1016/s1473-3099(17)30117-2.
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Keywords: Sepsis, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Outcomes
Sudduth CL, Overton EC, Lyu PF
Filtering authentic sepsis arising in the ICU using administrative codes coupled to a SIRS screening protocol.
Using administrative codes and minimal physiologic and laboratory data, researchers sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. They concluded that selected administrative codes coupled to SIRS criteria and applied to patients admitted to ICU can yield up to 94 percent authentic sepsis patients. However, only 1/3 of patients thus identified appeared to become septic during their ICU stay.
AHRQ-funded; HS000055.
Citation: Sudduth CL, Overton EC, Lyu PF .
Filtering authentic sepsis arising in the ICU using administrative codes coupled to a SIRS screening protocol.
J Crit Care 2017 Jun;39:220-24. doi: 10.1016/j.jcrc.2017.01.012.
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Keywords: Diagnostic Safety and Quality, Intensive Care Unit (ICU), Hospitalization, Sepsis
Bhattacharjee P, Churpek MM, Snyder A
Detecting sepsis: are two opinions better than one?
Researchers conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. They concluded that provider disagreement regarding suspected infection is common, with RNs suspecting infection more often, suggesting that a collaborative model for sepsis detection may improve timing and accuracy.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Churpek MM, Snyder A .
Detecting sepsis: are two opinions better than one?
J Hosp Med 2017 Apr;12(4):256-58. doi: 10.12788/jhm.2721.
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Keywords: Diagnostic Safety and Quality, Nursing, Risk, Sepsis
Bhattacharjee P, Edelson DP, Churpek MM
Identifying patients with sepsis on the hospital wards.
The goal of this review was to discuss recent advances in the detection of sepsis in patients on the hospital wards. The investigators discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening patients with sepsis, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick sepsis-related organ failure assessment (qSOFA) score.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Edelson DP, Churpek MM .
Identifying patients with sepsis on the hospital wards.
Chest 2017 Apr;151(4):898-907. doi: 10.1016/j.chest.2016.06.020..
Keywords: Clinical Decision Support (CDS), Diagnostic Safety and Quality, Hospitalization, Sepsis
Banerjee T, Meyer TW, Shafi T
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
P-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. The researchers explored the relationship between free and total PCS and indoxyl sulfate (IS) with infection-related hospitalizations (IH) and septicemia in 2 cohorts. Their results suggest an association between higher concentrations of free PCS and infection-related and sepsis-related hospitalizations in hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Banerjee T, Meyer TW, Shafi T .
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
Medicine 2017 Feb;96(6):e5799. doi: 10.1097/md.0000000000005799.
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Keywords: Hospitalization, Kidney Disease and Health, Kidney Disease and Health, Digestive Disease and Health, Sepsis
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis
Septimus EJ, Hayden MK, Kleinman K
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
The investigators determined rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. They demonstrated that universal decolonization with mupirocin and chlorhexidine bathing resulted in a significant reduction in blood culture contamination.
AHRQ-funded; 290201000008I; 290032007T.
Citation: Septimus EJ, Hayden MK, Kleinman K .
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S17-22. doi: 10.1086/677822.
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Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Sepsis