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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 25 of 31 Research Studies DisplayedKempker JA, Martin GS
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Sepsis disproportionately affects older adults (mean age, 65 yr); is predominantly community acquired (87%); is expensive (mean hospital costs $21,500); and is associated with high hospital mortality (one in eight patients) and high rates of 30-day readmission for survivors (one in eight patients). In this editorial, the authors discuss an article- by Paoli et al, published in 2018 in Volume 46 of Critical Care Medicine- on sepsis epidemiology.
AHRQ-funded; HS025240.
Citation: Kempker JA, Martin GS .
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Crit Care Med 2018 Dec;46(12):2043-44. doi: 10.1097/ccm.0000000000003376..
Keywords: Healthcare Costs, Mortality, Outcomes, Sepsis
Han RH, McKinnon A, CreveCoeur TS
Predictors of mortality for preterm infants with intraventricular hemorrhage: a population-based study.
This study examined the risk factors for mortality in preterm infants with intraventricular hemorrhage (IVH). An overall inpatient mortality occurred in 10% of the cohort of 7437 preterm infants born between 2005 and 2014. Mortality risk was independently associated with a variety of factors including male sex, Asian race, lower gestational age, higher IVH grade, gastrotomy, tracheostomy, and shunt infection.
AHRQ-funded; HS019455.
Citation: Han RH, McKinnon A, CreveCoeur TS .
Predictors of mortality for preterm infants with intraventricular hemorrhage: a population-based study.
Childs Nerv Syst 2018 Nov;34(11):2203-13. Epub ahead of print. doi: 10.1007/s00381-018-3897-4..
Keywords: Healthcare Cost and Utilization Project (HCUP), Mortality, Newborns/Infants, Outcomes
Kundi H, Valsdottir LR, Popma JJ
Impact of a claims-based frailty indicator on the prediction of long-term mortality after transcatheter aortic valve replacement in Medicare beneficiaries.
In this study, the investigators sought to characterize the prognostic importance of frailty factors as identified in healthcare billing records in comparison to validated measures of frailty for the prediction of long-term mortality after transcatheter aortic valve replacement (TAVR). The authors suggest that risk prediction models that include frailty as identified in claims data can be used to predict long-term mortality risk after TAVR.
AHRQ-funded; HS024520.
Citation: Kundi H, Valsdottir LR, Popma JJ .
Impact of a claims-based frailty indicator on the prediction of long-term mortality after transcatheter aortic valve replacement in Medicare beneficiaries.
Circ Cardiovasc Qual Outcomes 2018 Oct;11(10):e005048. doi: 10.1161/circoutcomes.118.005048..
Keywords: Medicare, Mortality, Surgery, Outcomes
Beg MS, Gupta A, Sher D
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Researchers examined the association of several medication classes on pancreatic cancer survival, using data from the Surveillance, Epidemiology, and End Results-Medicare database. They found that the use of beta-blockers, heparin, insulin, and warfarin were associated with improved survival in patients with pancreatic cancer, whereas metformin, thiazolidinedione, statin, and combination therapies were not. The authors recommended additional studies to validate these findings in the clinical setting.
AHRQ-funded; HS022418.
Citation: Beg MS, Gupta A, Sher D .
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis..
Keywords: Cancer, Medication, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Sakran JV, Mehta A, Fransman R
Nationwide trends in mortality following penetrating trauma: are we up for the challenge?
This study analyzed contemporary trends in pre-hospital mortality from penetrating trauma in the past decade using The National Trauma Data Bank. The authors concluded the odds of pre-hospital mortality has increased over 4-fold for gunshot wounds and almost 9-fold for stab wounds. Examining violence intensity, along with improvements in hospital care and data collection, may explain these findings.
AHRQ-funded; HS024547.
Citation: Sakran JV, Mehta A, Fransman R .
Nationwide trends in mortality following penetrating trauma: are we up for the challenge?
J Trauma Acute Care Surg 2018 Jul;85(1):160-66. doi: 10.1097/ta.0000000000001907..
Keywords: Injuries and Wounds, Mortality, Outcomes, Trauma
Banerjee M, Reyes-Gastelum D, Haymart MR
Treatment-free survival in patients with differentiated thyroid cancer.
This study evaluated treatment-free survival for 9273 patients who had differentiated thyroid cancer between 1998 and 2012. Most patients (75%) were female and median age at time of diagnosis was 69 years. The data was evaluated from the SEERS Program-Medicare registry. Five prognostic groups were identified and 5-year survival rates ranged from 96% down to 52%, and 10-year survival rates from 94% down to 39%. Factors for predicting survival rates were stage, tumor size, and treatment with radioactive iodine.
AHRQ-funded; HS024512.
Citation: Banerjee M, Reyes-Gastelum D, Haymart MR .
Treatment-free survival in patients with differentiated thyroid cancer.
J Clin Endocrinol Metab 2018 Jul;103(7):2720-27. doi: 10.1210/jc.2018-00511..
Keywords: Cancer, Mortality, Outcomes
Westover AN, Nakonezny PA, Halm EA
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. The investigators concluded that in their cohort comorbid substance use disorders were common and were risk factors for development of (AUD).
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Halm EA .
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
Addiction 2018 May;113(5):857-67. doi: 10.1111/add.14122..
Keywords: Substance Abuse, Medication, Risk, Mortality, Patient-Centered Outcomes Research, Outcomes
Austrian JS, Jamin CT, Doty GR
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
The goal of this study was to determine if an electronic health record (EHR) based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. A patient-level, interrupted time series study of emergency department patients with severe sepsis or septic shock was conducted, with an intervention introduced at the approximate mid-point--a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Mean length of stay for patients with sepsis decreased significantly following the introduction of the alert, but the alert system had no effect on mortality or other clinical or process measures. The researchers conclude that a more sophisticated algorithm for sepsis identification is needed to improve outcomes.
AHRQ-funded; HS023683.
Citation: Austrian JS, Jamin CT, Doty GR .
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
J Am Med Inform Assoc 2018 May;25(5):523-29. doi: 10.1093/jamia/ocx072..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Mortality, Outcomes, Quality Improvement, Quality of Care, Sepsis
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
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
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
Likosky DS, Van Parys J, Zhou W
Association between Medicare expenditure growth and mortality rates in patients with acute myocardial infarction: a comparison from 1999 through 2014.
This study assessed whether components of growth in Medicare expenditures are associated with mortality rates between January 1, 1999, and June 30, 2014, for beneficiaries hospitalized for acute myocardial infarction. It found that the growth in early percutaneous coronary intervention exhibited a negative association with 180-day case fatality. Spending on cardiac procedures was positively associated with 180-day mortality.
AHRQ-funded; HS022535.
Citation: Likosky DS, Van Parys J, Zhou W .
Association between Medicare expenditure growth and mortality rates in patients with acute myocardial infarction: a comparison from 1999 through 2014.
JAMA Cardiol 2018 Feb;3(2):114-22. doi: 10.1001/jamacardio.2017.4771.
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Keywords: Elderly, Medicare, Heart Disease and Health, Mortality, Outcomes
Burke RE, Jones CD, Hosokawa P
Influence of nonindex hospital readmission on length of stay and mortality.
The purpose of this study was to describe the prevalence of nonindex 30-day readmissions in a nationally representative sample of all payers and associations with outcomes. The investigators conclude that nonindex readmissions are common and associated with worse outcomes; the common findings across cohorts highlighted the importance for hospitals and care systems participating in value-based payment models.
AHRQ-funded; HS024569.
Citation: Burke RE, Jones CD, Hosokawa P .
Influence of nonindex hospital readmission on length of stay and mortality.
Med Care 2018 Jan;56(1):85-90. doi: 10.1097/mlr.0000000000000829..
Keywords: Hospitals, Mortality, Outcomes, Hospital Readmissions
Phillippi JC, Danhausen K, Alliman J
Neonatal outcomes in the birth center setting: a systematic review.
This systematic review examined the effects of the birth center setting on neonatal mortality in economically developed countries. The criteria for inclusion included being in English, published after 1980 and in countries with similar guidelines to the American Association of Birth Centers Standards. The only measure used was neonatal mortality and results did not find any difference between using a birth center as opposed to a traditional hospital setting. The literature was not found to have many good quality studies, and further research is recommended.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Danhausen K, Alliman J .
Neonatal outcomes in the birth center setting: a systematic review.
J Midwifery Womens Health 2018 Jan;63(1):68-89. doi: 10.1111/jmwh.12701..
Keywords: Evidence-Based Practice, Labor and Delivery, Mortality, Newborns/Infants, Outcomes, Pregnancy, Women
Scally CP, Yin H, Birkmeyer JD
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
The researchers compared high and low mortality hospitals in order to identify differences in patient care impacting safety. They concluded that high and low mortality hospitals both have high compliance with common quality measures; however, high mortality hospitals performed worse in other areas of perioperative care, indicating possible targets for quality improvement efforts.
AHRQ-funded; HS020937.
Citation: Scally CP, Yin H, Birkmeyer JD .
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
J Surg Oncol 2015 Dec;112(8):866-71. doi: 10.1002/jso.24085.
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Keywords: Surgery, Mortality, Quality Improvement, Outcomes, Patient Safety
Grenda TR, Revels SL, Yin H
Lung cancer resection at hospitals with high vs low mortality rates.
The objective of this study was to evaluate perioperative outcomes in patients who underwent lung cancer resection at high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) in order to better understand the factors related to differences in mortality rates after lung cancer resection. It concluded that failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection.
AHRQ-funded; HS000053; HS020937.
Citation: Grenda TR, Revels SL, Yin H .
Lung cancer resection at hospitals with high vs low mortality rates.
JAMA Surg 2015 Nov;150(11):1034-40. doi: 10.1001/jamasurg.2015.2199..
Keywords: Cancer: Lung Cancer, Surgery, Mortality, Outcomes, Patient Safety
Hu Y, McMurry TL, Stukenborg GJ
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
The purpose of this study was to characterize postesophagectomy readmissions and determine their relationship with subsequent 90-day mortality. It found that one in 5 esophagectomy patients are readmitted early after discharge. Readmitted patients have a 5-fold increase in early mortality.
AHRQ-funded; HS018049.
Citation: Hu Y, McMurry TL, Stukenborg GJ .
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
J Thorac Cardiovasc Surg 2015 Nov;150(5):1254-60. doi: 10.1016/j.jtcvs.2015.08.071..
Keywords: Hospital Readmissions, Mortality, Outcomes, Registries, Surgery
Kramer RD, Cooke CR, Liu V
Variation in the contents of sepsis bundles and quality measures. a systematic review.
The researchers sought to determine the degree of agreement on component elements of sepsis bundles and the associated timing goals for completion of each element. They also evaluated the amount of variation between metrics associated with bundles. They found that no bundle included metrics evaluating timeliness or completeness of sepsis recognition. Also, there was a lack of consensus on component elements and timing goals across highly recognized sepsis bundles.
AHRQ-funded; HS020672.
Citation: Kramer RD, Cooke CR, Liu V .
Variation in the contents of sepsis bundles and quality measures. a systematic review.
Ann Am Thorac Soc 2015 Nov;12(11):1676-84. doi: 10.1513/AnnalsATS.201503-163BC.
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Keywords: Sepsis, Mortality, Guidelines, Antimicrobial Stewardship, Outcomes
Hemmila MR, Osborne NH, Henke PK
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
The researchers examined the relationship between prophylactic inferior vena cava (IVC) filter use, mortality, and venous thromboembolic events (VTE). They found that high rates of prophylactic IVC filter placement have no effect on reducing trauma patient mortality and are associated with an increase in deep venous thromboembolism (DVT) events.
AHRQ-funded; HS018728.
Citation: Hemmila MR, Osborne NH, Henke PK .
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
Ann Surg 2015 Oct;262(4):577-85. doi: 10.1097/sla.0000000000001434..
Keywords: Blood Clots, Outcomes, Mortality, Injuries and Wounds, Prevention
Brooke BS, Goodney PP, Kraiss LW
Readmission destination and risk of mortality after major surgery: an observational cohort study.
This study examined the association between readmission destination and mortality risk in the USA in Medicare beneficiaries after a range of common operations. It found that patients who are readmitted to hospital after various major operations consistently achieve improved survival if they return to the hospital where their surgery took place.
AHRQ-funded; HS021581.
Citation: Brooke BS, Goodney PP, Kraiss LW .
Readmission destination and risk of mortality after major surgery: an observational cohort study.
Lancet 2015 Aug 29;386(9996):884-95. doi: 10.1016/s0140-6736(15)60087-3..
Keywords: Hospital Readmissions, Mortality, Surgery, Elderly, Outcomes, Hospitals
Bewtra M, Newcomb CW, Wu Q
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
This study sought to determine whether patients with advanced ulcerative colitis (UC) treated with elective colectomy have improved survival compared with those treated with medical therapy. It found that elective colectomy was associated with improved survival compared with long-term medical therapy, although this result did not remain statistically significant in all sensitivity analyses.
AHRQ-funded; HS018517.
Citation: Bewtra M, Newcomb CW, Wu Q .
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Ann Intern Med 2015 Aug 18;163(4):262-70. doi: 10.7326/m14-0960..
Keywords: Comparative Effectiveness, Mortality, Outcomes, Surgery, Digestive Disease and Health
Cauley RP, Potanos K, Fullington N
Pulmonary support on day of life 30 is a strong predictor of increased 1 and 5-year morbidity in survivors of congenital diaphragmatic hernia.
The researchers aimed to determine if the degree of pulmonary support (PS) on day of life 30 (DOL-30) could be a simple cross-institutional tool for identifying those patients with a higher risk of long-term morbidity. They found that PS on DOL-30 is a strong independent predictor of morbidity at 1 and 5-years and may be used as a simple prognostic tool to identify high-risk infants.
AHRQ-funded; HS019485.
Citation: Cauley RP, Potanos K, Fullington N .
Pulmonary support on day of life 30 is a strong predictor of increased 1 and 5-year morbidity in survivors of congenital diaphragmatic hernia.
J Pediatr Surg 2015 May;50(5):849-55. doi: 10.1016/j.jpedsurg.2014.12.007..
Keywords: Children/Adolescents, Mortality, Outcomes
Kumamaru H, Jalbert JJ, Nguyen LL
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
The objective of this study is to examine the decline in past-year case-volumes of surgeons performing carotid endarterectomy (CEA) before and after the National Coverage Determination (NCD) for carotid artery stenting (CAS) and to assess its effect on 30-day post-CEA mortality. It found that the rate of CEA procedures decreased substantially during 2001 to 2008. The postprocedural mortality in Medicare beneficiaries was high compared with trial patients.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
Stroke 2015 May;46(5):1288-94. doi: 10.1161/strokeaha.114.006276..
Keywords: Surgery, Mortality, Patient-Centered Outcomes Research, Outcomes, Elderly
Koroukian SM, Warner DF, Owusu C
Multimorbidity redefined: prospective health outcomes and the cumulative effect of co-occurring conditions.
The researchers explored the prospective effects of multimorbidity on health outcomes (health status, major health decline, and mortality). They found a strong and significant association between multimorbidity and prospective health status, major health decline, and mortality and concluded that multimorbidity may be used — both in clinical practice and in research — to identify older adults with heightened vulnerability for adverse outcomes.
AHRQ-funded; HS023113.
Citation: Koroukian SM, Warner DF, Owusu C .
Multimorbidity redefined: prospective health outcomes and the cumulative effect of co-occurring conditions.
Prev Chronic Dis 2015 Apr 23;12:E55. doi: 10.5888/pcd12.140478..
Keywords: Outcomes, Health Status, Mortality, Elderly
LeBlanc TW, Nipp RD, Rushing CN
Correlation between the international consensus definition of the Cancer Anorexia-Cachexia Syndrome (CACS) and patient-centered outcomes in advanced non-small cell lung cancer.
The researchers applied the recently posed weight-based international consensus CACS definition to a population of patients with advanced non-small cell lung cancer (NSCLC) and explored its impact on patient-reported outcomes. They concluded that it is useful in identifying patients with advanced NSCLC who are likely to have significantly inferior survival and who will develop more precipitous declines in physical function and QOL.
AHRQ-funded; HS022763.
Citation: LeBlanc TW, Nipp RD, Rushing CN .
Correlation between the international consensus definition of the Cancer Anorexia-Cachexia Syndrome (CACS) and patient-centered outcomes in advanced non-small cell lung cancer.
J Pain Symptom Manage 2015 Apr;49(4):680-9. doi: 10.1016/j.jpainsymman.2014.09.008..
Keywords: Cancer: Lung Cancer, Patient Safety, Quality of Life, Mortality, Outcomes