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AHRQ Research Studies Date
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- Adverse Events (1)
- Cardiovascular Conditions (1)
- (-) Children/Adolescents (10)
- Data (1)
- Disparities (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (3)
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- Healthcare Cost and Utilization Project (HCUP) (2)
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- (-) Sepsis (10)
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 10 of 10 Research Studies DisplayedSlatnick LR, Thornhill D, Deakyne Davies
Disseminated intravascular coagulation is an independent predictor of adverse outcomes in children in the emergency department with suspected sepsis.
The purpose of this study was to evaluate the impact of early disseminated intravascular coagulation (DIC) on illness severity in children using a database of emergency department ED encounters for children with suspected sepsis, in view of similar associations in adults. The investigators concluded that a DIC score of ≥3 was an independent predictor for both vasopressor use and mortality in this pediatric cohort, distinct from the adult overt DIC score cutoff of ≥5.
AHRQ-funded; HS025696.
Citation: Slatnick LR, Thornhill D, Deakyne Davies .
Disseminated intravascular coagulation is an independent predictor of adverse outcomes in children in the emergency department with suspected sepsis.
J Pediatr 2020 Oct;225:198-206.e2. doi: 10.1016/j.jpeds.2020.06.022..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Adverse Events, Mortality, Patient Safety, Outcomes
Scott HF, Brilli RJ, Paul R
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
The purpose of this study was to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and to evaluate the definition using a published framework. The investigators concluded that the Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated feasibility for large-scale data abstraction. When operationalized, these definitions enabled multicenter identification and data aggregation, indicating practical utility for quality improvement.
AHRQ-funded; HS025696.
Citation: Scott HF, Brilli RJ, Paul R .
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
Crit Care Med 2020 Oct;48(10):e916-e26. doi: 10.1097/ccm.0000000000004505..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis, Quality Improvement, Quality of Care
Gigli KH, Davis BS, Yabes JG
Pediatric outcomes after regulatory mandates for sepsis care.
The authors used hospital discharge data from 2011 to 2015 to compare changes in pediatric sepsis outcomes in New York and four control states following New York’s 2013 regulations mandating that hospitals develop pediatric-specific protocols for sepsis recognition and treatment. They found that implementation of statewide sepsis regulations was generally associated with improved mortality trends in New York State, particularly in prespecified subpopulations of patients, suggesting that the regulations were successful in affecting sepsis outcomes.
AHRQ-funded; HS025146.
Citation: Gigli KH, Davis BS, Yabes JG .
Pediatric outcomes after regulatory mandates for sepsis care.
Pediatrics 2020 Jul;146(1). doi: 10.1542/peds.2019-3353.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Sepsis, Outcomes, Hospitals
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
Scott HF, Colborn KL, Sevick CJ
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
The purpose of this observational cohort study was to derive and validate a model of risk of septic shock among children with suspected sepsis, using data known in the electronic health record at hospital arrival. The investigators concluded that their model estimated the risk of septic shock in children at hospital arrival earlier than existing models. They indicate it leveraged the predictive value of routine electronic health record data through a modern predictive algorithm and suggest it has the potential to enhance clinical risk stratification in the critical moments before deterioration.
AHRQ-funded; HS025696.
Citation: Scott HF, Colborn KL, Sevick CJ .
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
J Pediatr 2020 Feb;217:145-51.e6. doi: 10.1016/j.jpeds.2019.09.079..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Hospitals, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Hsu HE, Abanyie F, Agus MSD
A national approach to pediatric sepsis surveillance.
The authors described the challenges specific to pediatric sepsis surveillance. They then proposed a preliminary pediatric sepsis event surveillance definition and outlined next steps for refining and validating these criteria so that they may be used to estimate the national burden of pediatric sepsis and support site-specific surveillance to complement ongoing initiatives to improve sepsis prevention, recognition, and treatment.
AHRQ-funded; HS023827; HS025008.
Citation: Hsu HE, Abanyie F, Agus MSD .
A national approach to pediatric sepsis surveillance.
Pediatrics 2019 Dec;144(6). doi: 10.1542/peds.2019-1790..
Keywords: Children/Adolescents, Sepsis
Hartman ME, Saeed MJ, Powell KN
The comparative epidemiology of pediatric severe sepsis.
The purpose of this study was to determine if the coding strategies used to identify severe sepsis in administrative data sets could identify cases with comparable case mix, hospitalization characteristics, and outcomes as a cohort of children diagnosed with severe sepsis. HCUP data was used. Results showed that the ICD-9-CM codes for "severe sepsis" and "septic shock" identify smaller but higher acuity cohorts of patients that more closely resemble the children enrolled in the largest clinical trial of pediatric severe sepsis to date.
AHRQ-funded; HS019455.
Citation: Hartman ME, Saeed MJ, Powell KN .
The comparative epidemiology of pediatric severe sepsis.
J Intensive Care Med 2019 Jun;34(6):472-79. doi: 10.1177/0885066617735783..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Sepsis
Lindell RB, Nishisaki A, Weiss SL
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
This study compared the use of Virtual Pediatric Systems with traditional use of International Classification of Diseases, 9th edition (ICD) to identify children with severe sepsis or septic shock in PICU settings. Two different systems were compared “Martin” and “Angus”. Both showed good agreement, but ICD9 identified a smaller more accurate cohort of children. Additional analysis of discrepancies between the reference standard the two virtual systems showed that prospective screening missed 66 patients who were diagnosed with severe sepsis or severe shock. Once they were included in the standard cohort, agreement improved with a positive predictive value of 70%.
AHRQ-funded; HS024511; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
Crit Care Med 2019 Feb;47(2):e129-e35. doi: 10.1097/ccm.0000000000003541..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Data, Sepsis
Wheeler DS, Wong HR
Sepsis in pediatric cardiac intensive care.
The authors reviewed risk factors for developing sepsis; the role of biomarkers; and the pathophysiology and management of severe sepsis and septic shock. They concluded that while scientific advances in the diagnosis and clinical staging of sepsis offer tremendous promise for the future, it is also evident that sepsis mortality has not improved enough, even with progress in our understanding of the molecular pathophysiology of sepsis.
AHRQ-funded; HS020455.
Citation: Wheeler DS, Wong HR .
Sepsis in pediatric cardiac intensive care.
Pediatr Crit Care Med 2016 Aug;17(8 Suppl 1):S266-71. doi: 10.1097/pcc.0000000000000796.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Intensive Care Unit (ICU), Children/Adolescents, Sepsis
Kessler DO, Walsh B, Whitfill T
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
The authors sought to measure and compare adherence to pediatric sepsis guidelines across a spectrum of emergency departments. They found that among 47 teams across 24 emergency departments, adherent teams had significantly higher Emergency Medical Services for Children readiness scores, MD composition of physicians to total team members, teamwork scores, provider perceptions of pediatric preparedness, and provider perceptions of sepsis preparedness. They concluded that only composite team experience level of the providers was associated with improved guideline adherence.
AHRQ-funded; HS020286.
Citation: Kessler DO, Walsh B, Whitfill T .
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
J Emerg Med 2016 Mar;50(3):403-15.e1-3. doi: 10.1016/j.jemermed.2015.08.004.
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Keywords: Emergency Department, Disparities, Guidelines, Children/Adolescents, Sepsis