National Healthcare Quality and Disparities Report
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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
26 to 50 of 86 Research Studies DisplayedBucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
The purpose of this study was to evaluate a method for incorporating social risk variables into a pediatric measure of utilization from the Pediatric Quality Measures Program (PQMP). The researchers utilized data from California Medicaid claims (2015-16) and Massachusetts All Payer Claims Database (2014-2015) to assess health plan performance using the Pediatric Asthma Emergency Department Use measure. The study found that of 133 health plans serving 404,649 pediatric patients with asthma, 7% to 13% changed performance categories after social risk adjustment. Health plans that shifted to higher performance categories cared for lower socioeconomic status (SES) patients, while those that shifted to lower performance categories cared for higher SES patients. The study concluded that adjustment for social risk factors shifted performance rankings on the PQMP Pediatric Asthma Emergency Department Use measure for a large number of health plans.
AHRQ-funded; HS025297; HS025299.
Citation: Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE .
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
Acad Pediatr 2022 Apr;22(3s):S108-s14. doi: 10.1016/j.acap.2021.09.023..
Keywords: Children/Adolescents, Quality Measures, Quality of Care, Risk, Social Determinants of Health
Dixon DD, Xu M, Akwo EA
Depressive symptoms and incident heart failure risk in the Southern Community Cohort Study.
This study’s aim was to examine whether greater frequency of depressive symptoms associates with increased risk of incident heart failure (HF). The authors studied 23,937 Black or White Southern Community Cohort Study participants (median age: 53 years, 70% Black, 64% women) enrolled between 2002 and 2009, without prevalent HF, who were receiving Centers for Medicare and Medicaid Services coverage. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CESD-10) and incident HF ascertained from the Centers for Medicare and Medicaid Services International Classification of Diseases-9th Revision (ICD-9) (code: 428.x) and ICD-10 (codes: I50, I110) codes through December 31, 2016. The median CESD-10 score was 9. Over a median 11-year follow-up, 25% of participants developed HF. The strongest correlates of depressive symptoms were antidepressant medication use, age, and socioeconomic factors, rather than traditional HF risk factors. Greater frequency of depressive symptoms was associated with increased incident HF risk without variation by race or sex.
AHRQ-funded; HS026395.
Citation: Dixon DD, Xu M, Akwo EA .
Depressive symptoms and incident heart failure risk in the Southern Community Cohort Study.
JACC Heart Fail 2022 Apr;10(4):254-62. doi: 10.1016/j.jchf.2021.11.007..
Keywords: Depression, Heart Disease and Health, Cardiovascular Conditions, Risk
Kim HN, Nance RM, Lo Re V
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
The authors developed and validated a risk-prediction model for end-stage liver disease (ESLD) among people with HIV (PWH). They developed and validated a risk prediction model for ESLD among PWH who received care in 12 cohorts of the North American AIDS Cohort Collaboration on Research and Design and found that their model of readily accessible clinical parameters predicted ESLD in a large diverse population of PWH.
AHRQ-funded; 90047713.
Citation: Kim HN, Nance RM, Lo Re V .
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
J Acquir Immune Defic Syndr 2022 Apr;89(4):396-404. doi: 10.1097/qai.0000000000002886..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Risk
Chu DK, Abrams EM, Golden BK
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
The purpose of this systematic review and meta-analysis of case studies and case reports was to assess the risk of severe immediate allergic reactions to a second dose of SARS-CoV-2 mRNA vaccine in people who experienced an immediate allergic reaction to the first dose. The researchers evaluated the World Health Organization Global Coronavirus database, Web of Science, MEDLINE, and Embase from the date of inception through October 4th, 2021. The main outcomes and measures were a risk of severe immediate allergic reaction and repeated severe immediate allergic reactions with a second vaccine dose. The study found that among 22 studies of SARS-CoV-2 mRNA vaccines, 1366 individuals had immediate allergic reactions to their first vaccination. Of these, 87.8% were women with a mean age of 46.1 years. Six patients developed severe immediate allergic reactions after their second vaccination, 232 developed mild symptoms, and 1360 tolerated the dose. Among 78 persons with severe immediate allergic reactions to their first SARS-CoV-2 mRNA vaccination, 4 people had a second severe immediate reaction, and 15 had non-severe symptoms. There were no deaths. The study concluded that in a supervised setting equipped to manage severe allergic reactions, revaccination of individuals with an immediate allergic reaction to a first SARS-CoV-2 mRNA vaccine dose can be safe.
AHRQ-funded; HS026395.
Citation: Chu DK, Abrams EM, Golden BK .
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
JAMA Intern Med 2022 Apr;182(4):376-85. doi: 10.1001/jamainternmed.2021.8515..
Keywords: COVID-19, Vaccination, Risk, Evidence-Based Practice, Patient-Centered Outcomes Research
Jacobsohn GC, Leaf M, Liao F
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
The authors used a collaborative and iterative approach to design and implement an automated clinical decision support system (CDS) for Emergency Department (ED) providers to identify and refer older adult ED patients at high risk of future falls. The system was developed using collaborative input from an interdisciplinary design team and integrated seamlessly into existing ED workflows. A key feature of development was the unique combination of patient experience strategies, human-centered design, and implementation science, which allowed for the CDS tool and intervention implementation strategies to be designed simultaneously. Challenges included: usability problems, data inaccessibility, time constraints, low appointment availability, high volume of patients, and others. The study concluded that using the collaborative, iterative approach was successful in achieving all project goals, and could be applied to other cases.
AHRQ-funded; HS024558.
Citation: Jacobsohn GC, Leaf M, Liao F .
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
Healthc 2022 Mar;10(1):100598. doi: 10.1016/j.hjdsi.2021.100598..
Keywords: Elderly, Clinical Decision Support (CDS), Decision Making, Falls, Risk, Emergency Department, Health Information Technology (HIT)
Ellis RP, Hsu HE, Siracuse JJ
Development and assessment of a new framework for disease surveillance, prediction, and risk adjustment: the diagnostic items classification system.
The purpose of this study was to develop an updated classification framework for predicting diverse health care payment, quality, and performance outcomes, based on the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). All ICD-10-CM diagnoses were mapped into 3 types of diagnostic items (DXIs): main effect DXIs that specify diseases; modifiers, such as timing and acuity; and scaled variables, such as body mass index, gestational age, and birth weight. The primary outcome was annual health care spending top-coded at $250 000, and the researchers predicted 14 different outcomes, including: hospital days and admissions; emergency department visits; enrollee out-of-pocket spending; spending for 6 types of services; and overall and plan-paid health care spending. The researchers created 3223 DXIs: 2435 main effects, 772 modifiers, and 16 scaled items. The study found that relative to HHS-HCCs, the use of DXIs reduced underpayment for enrollees with rare diagnoses by 83%. The researchers concluded that in this study, for all spending and utilization outcomes considered, the new DXI classification system demonstrated improved predictions over current diagnostic classification systems.
AHRQ-funded; HS026485
Citation: Ellis RP, Hsu HE, Siracuse JJ .
Development and assessment of a new framework for disease surveillance, prediction, and risk adjustment: the diagnostic items classification system.
JAMA Health Forum 2022 Mar;3(3):e220276. doi: 10.1001/jamahealthforum.2022.0276..
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Keywords: Risk, Research Methodologies
Kleinman LC, Howell EA
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
The researchers report that in the context of quality improvement research, risk adjustment (RA) methods can obscure disparities in health care. In this study the researchers address the impact of considering equity when conducting risk adjustments in pediatric health, and describe the danger of veiled justice, a type of overadjustment that takes place when risk adjustments obscure real disparities because more than one covariate, such as race and socioeconomic status, are on related causal paths. Underadjustment can occur when these same structural characteristics are not addressed when calculating models of payment. The purpose of this study was to describe the literature and present a conceptual framework that identifies these two problems for validity related to the interactions between risk adjustment and health equity in pediatric health care. The researchers conclude that the science of quality improvement must address issues of health equity as an essential construct, with the development of a specific conceptual model. Statistical analysis should be interpreted using the conceptual model, and the dynamics of child development and life course should also be addressed, as well as additional contextual and process factors such as the role of caregivers and public insurance, the epidemiology of the disease, family financial status, and others. The goal of RA is to make valid conclusions such that observed differences can be attributed to the relevant causes. When higher risk is attributed to social determinants and not disease differences, RA can obscure disparities (veiled injustice) and differences at the population level and experienced by individuals are falsely hidden. Not addressing these same structural characteristics when calculating models of payment can lead to patterns of underadjustment. The authors advise that these 2 sides of a similar coin reveal the critical importance of both the underlying model and the capacity to reliably evaluate disparities and quality.
AHRQ-funded; HS020518; 233201550088A.
Citation: Kleinman LC, Howell EA .
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
Pediatrics 2022 Mar;149(Suppl 3). doi: 10.1542/peds.2020-045948G.
Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Risk
Di M, Keeney T, Belanger E
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
The objective of this study was to examine the impact of global risk on treatment selection and outcomes among older home care recipients with diffuse large B-cell lymphoma. Researchers selected patients diagnosed with diffuse large B-cell lymphoma who had pretreatment Outcome and Assessment Information Set (OASIS) evaluations from SEER-Medicare. High-risk patients were less likely to receive chemotherapy and were more likely to experience acute mortality, emergency department visits, hospitalization or intensive care unit admission, and had inferior overall survival rates. The researchers concluded that global risk on the basis of OASIS was easily available and offered a potential way to improve patient selection for curative treatment and institution of preventive measures.
AHRQ-funded; HS000011.
Citation: Di M, Keeney T, Belanger E .
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
JCO Oncol Pract 2022 Mar; 18(3):e383-e402. doi: 10.1200/op.21.00513..
Keywords: Elderly, Cancer, Risk
Wei YJ, Chen C, Lewis MO
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
This study used a sample of older patients who are Medicare beneficiaries who were newly prescribed opioids to determine rates of 4 prescription opioid dose trajectories and the risk of opioid-related adverse events (ORAEs). A 5% random sample of Medicare beneficiaries from 2011 to 2018 was used to conduct a nested case-control study of patients age 65 and older who were newly diagnosed with chronic noncancer pain (CNCP). Among the cases and controls, 2,192 (70.6%) were women and mean age was 77.1 years. Four prescribed opioid trajectories before the incident ORAE diagnosis or matched date emerged: gradual dose discontinuation (from ≤3 to 0 daily morphine milligram equivalent (MME), 1,456 [23.5%]), gradual dose increase (from 0 to >3 daily MME, 1,878 [30.3%]), consistent low dose (between 3 and 5 daily MME, 1,510 [24.3%]), and consistent moderate dose (>20 daily MME, 1,362 [22.0%]). Less than 5% were prescribed a mean daily dose of ≥90 daily MME during 6 months before diagnosis or matched date. Patients with gradual dose discontinuation versus those with a consistent low or moderate dose, and increase dose were more likely to be 65 to 74 years, Midwest US residents, and receiving no low-income subsidy. Those with gradual dose increase and consistent moderate dose had a higher risk of ORAE, after adjustment for covariates.
AHRQ-funded; HS027230.
Citation: Wei YJ, Chen C, Lewis MO .
Trajectories of prescription opioid dose and risk of opioid-related adverse events among older Medicare beneficiaries in the United States: a nested case-control study.
PLoS Med 2022 Mar;19(3):e1003947. doi: 10.1371/journal.pmed.1003947..
Keywords: Elderly, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Chronic Conditions, Pain, Substance Abuse, Behavioral Health, Medication: Safety, Patient Safety
Zhang NJ, Rameau P, Julemis M
Automated pulmonary embolism risk assessment using the Wells criteria: validation study.
The authors sought to create an automated process to calculate the Wells score for pulmonary embolism for emergency department patients, which might reduce unnecessary computed tomography pulmonary angiography (CTPA) testing. They designed the process using electronic health records data elements, including free-text fields, and calculated Wells scores for a sample of adult emergency department visits that resulted in a CTPA study for pulmonary embolism at two tertiary care hospitals in New York. After validation, the authors concluded that the development of the automated process to classify risk for pulmonary embolism in emergency department visits was successful.
AHRQ-funded; HS026196.
Citation: Zhang NJ, Rameau P, Julemis M .
Automated pulmonary embolism risk assessment using the Wells criteria: validation study.
JMIR Form Res 2022 Feb 28;6(2):e32230. doi: 10.2196/32230.
Keywords: Blood Clots, Respiratory Conditions, Risk, Emergency Department
Kamran F, Tang S, Otles E
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
The authors sought to create and validate a simple and transferable machine learning model from electronic health record data to accurately predict clinical deterioration in patients with COVID-19 across institutions, through use of a novel paradigm for model development and code sharing. They determined that a model to predict clinical deterioration was developed rapidly in response to the COVID-19 pandemic at a single hospital, was applied externally without the sharing of data, and performed well across multiple medical centers, patient subgroups, and time periods, showing its potential as a tool for use in optimizing healthcare resources.
AHRQ-funded; HS028038.
Citation: Kamran F, Tang S, Otles E .
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
BMJ 2022 Feb 17;376:e068576. doi: 10.1136/bmj-2021-068576..
Keywords: COVID-19, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Flannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
AHRQ-funded; HS027468.
Citation: Flannery DD, Mukhopadhyay S, Morales KH .
Delivery characteristics and the risk of early-onset neonatal sepsis.
Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Carpenter K, Scavotto M, McGovern A
Early parental knowledge of late effect risks in children with cancer.
This study assessed early parental knowledge of late effect risks in children with cancer. The cohort included parents of children receiving cancer treatment at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. The parents were surveyed about their knowledge of their child’s likelihood of eight late effects. Only 11 out of 96 parents correctly identified all their child’s risk for the eight late effects. Five of eight effects were the median number of correctly identified late effect risks. Among the 21 parents whose children were at risk for ototoxicity, 95% correctly identified this risk. Conversely, parents were less knowledgeable about risks of second malignancy, cardiac toxicity, neurocognitive impairment, and infertility.
AHRQ-funded; HS022986.
Citation: Carpenter K, Scavotto M, McGovern A .
Early parental knowledge of late effect risks in children with cancer.
Pediatr Blood Cancer 2022 Feb;69(2):e29473. doi: 10.1002/pbc.29473..
Keywords: Children/Adolescents, Cancer, Risk, Education: Patient and Caregiver, Health Literacy
Yunusa I, Gagne JJ, Yoshida K
Risk of opioid overdose associated with concomitant use of oxycodone and selective serotonin reuptake inhibitors.
Oxycodone is a potent prescription opioid. Some Selective Serotonin Reuptake Inhibitors (SSRIs) inhibit oxycodone metabolism in the body, but the clinical consequences of this interaction on overdose risk have not been adequately determined. The study researchers compared the rates of opioid overdoses in patients who had initiated oxycodone while taking enzyme-inhibiting SSRIs with the overdose rates of patents who had initiated oxycodone while taking non-enzyme inhibiting SSRIs. Data from 3 U.S. health insurance databases was used to analyze a cohort of adults who initiated oxycodone while receiving SSRI therapy between the years 2000 and 2020. Of the total of 2,037,490 who initiated oxycodone, 69.6% were receiving SSRIs at the time of the initiation of the oxycodone. One-thousand-thirty-five overdose events were observed during this time, and the resulting incidence rate in those initiating oxycodone while using enzyme-inhibiting SSRI’s was higher than in those using other SSRIs. The researchers concluded that in the study cohort of U.S. adults, there is a small increased risk of opioid overdose when initiating oxycodone in patients taking enzyme-inhibiting SSRIs.
AHRQ-funded; HS027623.
Citation: Yunusa I, Gagne JJ, Yoshida K .
Risk of opioid overdose associated with concomitant use of oxycodone and selective serotonin reuptake inhibitors.
JAMA Netw Open 2022 Feb;5(2):e220194. doi: 10.1001/jamanetworkopen.2022.0194..
Keywords: Opioids, Medication, Risk, Depression, Adverse Drug Events (ADE), Adverse Events
Fatemi P, Zhang Y, Han SS
A, et al. External validation of a predictive model of adverse events following spine surgery.
The authors externally validated a previously developed predictive model for common 30-day adverse events after spine surgery, the Risk Assessment Tool for Adverse Events after Spine Surgery (RAT-Spine). Their results are presented as low-, moderate-, and high-risk designations.
AHRQ-funded; HS023800.
Citation: Fatemi P, Zhang Y, Han SS .
A, et al. External validation of a predictive model of adverse events following spine surgery.
Spine J 2022 Jan;22(1):104-12. doi: 10.1016/j.spinee.2021.06.006..
Keywords: Surgery, Adverse Events, Orthopedics, Risk
Squires A, Ma C, Miner S
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. The objective of this retrospective cross-sectional study was to determine if home care patients' language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge.
AHRQ-funded; HS023593.
Citation: Squires A, Ma C, Miner S .
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
Int J Nurs Stud 2022 Jan;125:104093. doi: 10.1016/j.ijnurstu.2021.104093..
Keywords: Cultural Competence, Home Healthcare, Hospital Readmissions, Risk, Communication
Mallela DP, Canner JK, Zarkowsky DS
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
This study investigated the association of race on carotid endarterectomy (CEA) outcomes. Perioperative outcomes (at 30 days) were compared for Black vs. White patients adjusting for age/sex, comorbidities and disease characteristics. Out of 16,764 patients from the ACS-NSQIP targeted vascular database (2011-2019), 95.2% were White and 4.8% were Black. Black patients were slightly younger and more frequently (79.5% vs 74.0%) had high-grade carotid artery stenosis compared to White patients. Comorbidities including hypertension, diabetes, kidney disease, congestive heart failure, and coronary artery disease were all more prevalent among Black patients. Crude perioperative stroke and stroke/death were higher for Black patients, but myocardial infarction leading to death were similar. After adjusting for baseline differences between groups, the risk of perioperative stroke and stroke/death remained significantly higher for Black patients than White patients.
AHRQ-funded; HS024547.
Citation: Mallela DP, Canner JK, Zarkowsky DS .
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
J Am Coll Surg 2022 Jan;234(1):65-73. doi: 10.1097/xcs.0000000000000016..
Keywords: Racial and Ethnic Minorities, Surgery, Cardiovascular Conditions, Stroke, Risk, Adverse Events
Frehn JL, Brewster AL, Shortell SM
Comparing health care system and physician practice influences on social risk screening.
This study examined the association of multilevel organizational capabilities and adoption of social risk screening among system-owned physician practices. A secondary analysis of the 2018 National Survey of Healthcare Organizations and Systems data was conducted. Five social risks were used as measures for physician and system screening: food insecurity, housing instability, utility needs, interpersonal violence, and transportation needs. System-owned practices screened an average of 1.7 of the 5 social risks assessed. The differences were 16% attributable to practice variation between their health system owners, and 84% attributable to differences between individual practices. Practices owned by hospital systems screened for an additional 0.44 social risks relative to practices of systems without hospitals. Characteristics associated with more social risk screening included health information technology capacity, innovation culture, and patient engagement strategies.
AHRQ-funded; HS024075; HS022241.
Citation: Frehn JL, Brewster AL, Shortell SM .
Comparing health care system and physician practice influences on social risk screening.
Health Care Manage Rev 2022 Jan-Mar;47(1):E1-e10. doi: 10.1097/hmr.0000000000000309..
Keywords: Health Systems, Social Determinants of Health, Screening, Risk
Boehme AK, Oka M, Cohen B
Readmission rates in stroke patients with and without infections: incidence and risk factors.
Investigators examined whether an infection acquired during the initial stroke admission contributed to increased risk of readmission and infection during readmission. Their a retrospective cohort study incorporated all adult ischemic stroke patients 2006-2016 from three New York City hospitals. They found that, among stroke patients, healthcare-associated infections and infections present on admission were predictors of readmission within 60 days and infection during readmission.
AHRQ-funded; HS024915.
Citation: Boehme AK, Oka M, Cohen B .
Readmission rates in stroke patients with and without infections: incidence and risk factors.
J Stroke Cerebrovasc Dis 2022 Jan;31(1):106172. doi: 10.1016/j.jstrokecerebrovasdis.2021.106172..
Keywords: Stroke, Cardiovascular Conditions, Hospital Readmissions, Risk, Healthcare-Associated Infections (HAIs)
Herzig SJ, Anderson TS,, Jung y
Risk factors for opioid-related adverse drug events among older adults after hospital discharge.
This study examined patient- and prescribing-related risk factors for opioid-related adverse drug events (ADEs) after hospital discharge among medical patients. Administrative billing codes and medication claims were used to define potential opioid-related ADEs within 30 days of hospital discharge. Findings showed that potential opioid-related ADEs occurred in 7% of older adults discharged from a medical hospitalization with an opioid prescription. Recommendations included using identified risk factors to inform physician decision-making, having conversations with older adults about risk, and increasing development and targeting of harm reduction strategies.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS,, Jung y .
Risk factors for opioid-related adverse drug events among older adults after hospital discharge.
J Am Geriatr Soc 2022 Jan;70(1):228-34. doi: 10.1111/jgs.17453..
Keywords: Elderly, Opioids, Risk, Adverse Drug Events (ADE), Adverse Events, Medication, Hospital Discharge
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
Bobb JF, Obermeyer Z, Wang Y
Cause-specific risk of hospital admission related to extreme heat in older adults.
The purpose of this study was to identify possible causes of hospital admissions during extreme heat events and to estimate their risks using historical data. The investigators found that among older adults, periods of extreme heat were associated with increased risk of hospitalization for fluid and electrolyte disorders, renal failure, urinary tract infection, septicemia, and heat stroke. They noted however, that the absolute risk increase was small and of uncertain clinical importance.
AHRQ-funded; HS021991.
Citation: Bobb JF, Obermeyer Z, Wang Y .
Cause-specific risk of hospital admission related to extreme heat in older adults.
JAMA 2014 Dec 24-31;312(24):2659-67. doi: 10.1001/jama.2014.15715..
Keywords: Elderly, Hospitalization, Risk
Singh JA, Lewallen DG
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
The researchers examined the time-trends in key demographic and clinical characteristics of patients undergoing primary total hip arthroplasty (THA). They found that obesity, medical and psychological comorbidity increased and the underlying diagnosis of RA/inflammatory arthritis decreased rapidly in primary THA patients over 13-years.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
BMC Musculoskelet Disord 2014 Dec 17;15:441. doi: 10.1186/1471-2474-15-441..
Keywords: Surgery, Obesity, Risk, Registries, Arthritis
Bhavsar NA, Bream JH, Meeker AK
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
The authors evaluated the association between peripheral-cytokine concentrations and prostate cancer. They found that men with a prediagnostic circulating TH1 profile and higher IL6 may have a lower risk of prostate cancer, including aggressive disease. They concluded that identifying specific inflammatory cytokines associated with prostate cancer may lead to improved prevention and treatment strategies.
AHRQ-funded; HS019488.
Citation: Bhavsar NA, Bream JH, Meeker AK .
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2561-7. doi: 10.1158/1055-9965.epi-14-0010.
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Keywords: Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Risk
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