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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 18 of 18 Research Studies DisplayedPatel 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
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Goldstein E, MacFadden DR, Karaca Z
AHRQ Author: Karaca Z Steiner CA
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Researchers studied the relation between the prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. They found that, among the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50 years, and with sepsis mortality rates for individuals aged 18-84 years. They also found a number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults.
AHRQ-authored.
Citation: Goldstein E, MacFadden DR, Karaca Z .
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Int J Antimicrob Agents 2019 Jul;54(1):23-34. doi: 10.1016/j.ijantimicag.2019.03.004..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospitalization, Medication, Mortality, Sepsis
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
Weir RE, Lyttle CS, Meltzer DO
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
In this observational study, the investigators sought to compare the relative value of several methodologies by which comorbidities may be ascertained. The authors concluded that although comorbidities derived through administrative data did produce an area under the curve greater than chart review, their analyses suggested a coding bias in several comorbidities with a paradoxically protective effect. They assert that chart review, while labor and resource intensive, may be the ideal method for ascertainment of clinically relevant comorbidities.
AHRQ-funded; HS016948; HS010597.
Citation: Weir RE, Lyttle CS, Meltzer DO .
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
Med Care 2018 Nov;56(11):950-55. doi: 10.1097/mlr.0000000000000989..
Keywords: Community-Acquired Infections, Hospitalization, Mortality, Pneumonia
Desai NR, Ott LS, George EJ
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
The objectives of this study were to investigate the association between hospital-level 30-day risk-standardized mortality rates (RSMRs) and 30-day risk-standardized payments (RSPs) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNA); to characterize patterns of value in care; and to identify hospital characteristics associated with high-value care (defined by having lower than median RSMRs and RSPs).
AHRQ-funded; HS023000.
Citation: Desai NR, Ott LS, George EJ .
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
JAMA Netw Open 2018 Oct 5;1(6):e183519. doi: 10.1001/jamanetworkopen.2018.3519..
Keywords: Cardiovascular Conditions, Elderly, Hospitalization, Hospitals, Heart Disease and Health, Inpatient Care, Medicare, Mortality, Pneumonia
Lin MY, Kressin NR, Paasche-Orlow MK
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
This study’s objective was to verify other studies that showed that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition was lower among blacks than whites. Inpatient discharge and vital status data was used for patients 18 and older hospitalized in California from January 2010 to June 30, 2011 for a variety of acute conditions. Their analysis verified lower risk of mortality among blacks. Factors for this may be associated with a higher rate of hospitalization with an 80% risk and inpatient mortality was also 30% higher with whites than blacks.
AHRQ-funded; HS022242.
Citation: Lin MY, Kressin NR, Paasche-Orlow MK .
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
Med Care 2018 Aug;56(8):665-72. doi: 10.1097/mlr.0000000000000938..
Keywords: Hospitalization, Mortality, Racial and Ethnic Minorities
Kalbaugh CA, Loehr L, Wruck L
Frequency of care and mortality following an incident diagnosis of peripheral artery disease in the inpatient or outpatient setting: the ARIC (Atherosclerosis Risk in Communities) study.
Researchers analyzed frequency of care and mortality date for patients with an initial peripheral artery disease (PAD) diagnosis in the outpatient or inpatient setting. Data was analyzed from the ARIC (Atherosclerosis Risk in Communities) study cohort linked with Centers for Medicare and Medicaid Services fee-for-services claims data for 2002-2012. Patients diagnosed in the outpatient setting had higher follow-up rates with lower hospitalizations and mortality than those diagnosed in the inpatient setting.
AHRQ-funded; HS000032; HS023728.
Citation: Kalbaugh CA, Loehr L, Wruck L .
Frequency of care and mortality following an incident diagnosis of peripheral artery disease in the inpatient or outpatient setting: the ARIC (Atherosclerosis Risk in Communities) study.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007332..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Hospitalization, Mortality, Outcomes
de Cordova PB
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services.
The author comments on a study by Walker that explained the weekend effect as arising from differences in patient characteristics among patients who present to the emergency department on the weekend. For staffing, Walker used a proxy measure because staffing information was not available. The author cautions that, although a clear rationale was provided, there should be acknowledgement that use of a proxy, whether for illness severity or staffing, may alter results.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services.
Evid Based Nurs 2018 Apr;21(2):49. doi: 10.1136/eb-2017-102779.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Hospitalization, Mortality, Provider Performance
Hirayama A, Goto T, Shimada YJ
Association of obesity with severity of heart failure exacerbation: a population-based study.
Researchers investigate the associations of obesity with severity of heart failure exacerbation and in-hospital mortality using population-based data from the State Inpatient Databases. Subjects were adults hospitalized for heart failure exacerbation in seven States from 2012 to 2013. The researchers found that, based on large population-based data sets of patients with heart failure exacerbation, obesity was associated with higher acute severity measures but lower in-hospital mortality.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Association of obesity with severity of heart failure exacerbation: a population-based study.
J Am Heart Assoc 2018 Mar 15;7(6). doi: 10.1161/jaha.117.008243..
Keywords: Healthcare Cost and Utilization Project (HCUP), Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Mortality
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Goodwin JS, Salameh H, Zhou J
Association of hospitalist years of experience with mortality in the hospitalized Medicare population.
The purpose of the study is to describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. The authors noted that patients cared for by hospitalists in their first year of practice experienced higher mortality. The authors asserted that early-career hospitalists may require additional support to ensure optimal outcomes for their patients.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Salameh H, Zhou J .
Association of hospitalist years of experience with mortality in the hospitalized Medicare population.
JAMA Intern Med 2018 Feb;178(2):196-203. doi: 10.1001/jamainternmed.2017.7049..
Keywords: Hospitalization, Inpatient Care, Medicare, Mortality, Provider
Goto T, Hirayama A, Faridi MK
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
A study was done to determine if there was an increase in severity and mortality with chronic obstructive pulmonary disease (COPD) patients who were also obese. Researchers used data from 2012-2013 State Inpatient Databases data of seven U.S. states. 17% of COPD patients in the database were defined as obese. Obesity was shown to increase use of ventilation, increased hospital stays but not in-hospital mortality.
AHRQ-funded; HS023305.
Citation: Goto T, Hirayama A, Faridi MK .
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2018 Feb;15(2):184-91. doi: 10.1513/AnnalsATS.201706-485OC..
Keywords: Chronic Conditions, Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Obesity
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life
Chaudhry SI, Khan RF, Chen J
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
The investigators evaluated changes in the incidence of 1-year recurrent acute myocardial infarction (AMI) hospitalization and mortality. In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, they found that hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period.
AHRQ-funded; HS018781.
Citation: Chaudhry SI, Khan RF, Chen J .
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
J Am Heart Assoc 2014 Oct;3(5):e001197. doi: 10.1161/jaha.114.001197.
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Keywords: Hospitalization, Medicare, Mortality, Heart Disease and Health, Risk
Buys DR, Roth DL, Ritchie CS
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
This study finds that nutritional risk was prospectively associated with all-cause and nonsurgical hospitalizations and with nursing home admission and mortality in unadjusted models. After adjusting for other risk factors, the association between high nutritional risk and all-cause and nonsurgical hospitalizations remained significant.
AHRQ-funded; HS013852
Citation: Buys DR, Roth DL, Ritchie CS .
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1146-53. doi: 10.1093/gerona/glu024..
Keywords: Nutrition, Hospitalization, Elderly, Long-Term Care, Mortality
Bates BE, Xie D, Kwong PL
One-year all-cause mortality after stroke: a prediction model.
Using data from Department of Veterans Affairs (VA) national databases, the researchers present and internally validate a 1-year all-cause mortality prediction index after hospitalization for acute stroke. They conclude that a simple index using readily available data that stratifies stroke patients at the time of discharge according to low, moderate, high, and highest likelihood of all-cause 1-year mortality is feasible.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL .
One-year all-cause mortality after stroke: a prediction model.
PM R 2014 Jun;6(6):473-83. doi: 10.1016/j.pmrj.2013.11.006..
Keywords: Stroke, Mortality, Hospitalization
Patel RB, Mathur MB, Gould M
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
The researchers for this international study sought to model individuals at highest risk of mortality from HPAI N5N1 virus infection in order to inform preventive and therapeutic interventions. They found that age, health expenditure, delay from symptom onset to hospitalization and country are significant predictors of mortality.
AHRQ-funded; HS019816
Citation: Patel RB, Mathur MB, Gould M .
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
PLoS One. 2014 Mar 25;9(3):e91630. doi: 10.1371/journal.pone.0091630..
Keywords: Influenza, Mortality, Critical Care, Hospitalization, Risk