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Topics
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
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- Comparative Effectiveness (1)
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- Healthcare-Associated Infections (HAIs) (1)
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- (-) Outcomes (7)
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- (-) Respiratory Conditions (7)
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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 7 of 7 Research Studies DisplayedHaessler S, Guo N, Deshpande A
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
This study compared the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. The definition for sCAP includes a principal diagnosis of pneumonia or a secondary pneumonia diagnosis paired with a principal diagnosis of sepsis or respiratory failure. One-hundred seventy-seven US hospitals within the Premier Healthcare Database were used to identify 154,799 patients with pneumonia, with 14.1% meeting criteria for sCAP. The sCAP patients had higher organ failure scores and inpatient mortality, longer lengths of stay, and higher costs than those with nonsevere disease. Patients with sCAP had twice the rate of positive blood cultures and respiratory cultures and more often had isolates resistant to first-line community-acquired pneumonia antibiotics. The most common pathogen acquired from blood cultures was Streptococcus pneumoniae and from the respiratory tract Staphylococcus aureus and Pseudomonas species. The most common antibiotics prescribed were vancomycin (65%) and piperacillin-tazobactam (42.8%), regardless of cultures positive for a resistant organism.
AHRQ-funded; HS024277.
Citation: Haessler S, Guo N, Deshpande A .
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
Crit Care Med 2022 Jul;50(7):1063-71. doi: 10.1097/ccm.0000000000005498..
Keywords: Community-Acquired Infections, Pneumonia, Respiratory Conditions, Outcomes
Anesi GL, Liu VX, Chowdhury M
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
ICU capacity is strained and its capacity and effectiveness are limited because many patient admission decisions are not evidence-based regarding who benefits from admission triage. The purpose of the study was to measure the benefits of admission to the ICU in patients who were experiencing sepsis or acute respiratory failure. Researchers looked retrospectively from 2013 to 2018 at cohorts within 27 U.S. hospitals across two health systems. They compared ICU admission vs ward admission among patients with sepsis and/ or acute respiratory failure who did not require vasopressors or mechanical ventilation in the emergency department. Study results revealed in patients with sepsis that ICU admission was associated with a hospital stay of 1.32 days longer than ward admissions, with a higher in-hospital mortality ratio. In patients with respiratory failure, ICU admission was associated with a .82-day shorter length of stay and reduced in-patient mortality. Within the two groups, subgroup analysis was conducted, and results revealed that for patients with sepsis, harms were concentrated among older patients and patients with fewer comorbidities. In addition, for patients with respiratory failure, the benefits were concentrated among older patients, patients with higher lab-based acute physiology scores (“high acuity” patients), and patients with comorbidities. The study concluded that among sepsis patients with high acuity scores and not requiring life support in the emergency department, initial admission to the ward was associated with shorter length of stay and improved survival, compared to the same category of patients admitted to the ICU. This result differed from patients with acute respiratory failure, for whom triage to the ICU was associated with improved survival when compared to admission to the ward.
AHRQ-funded; HS026372.
Citation: Anesi GL, Liu VX, Chowdhury M .
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
Am J Respir Crit Care Med 2022 Mar 1;205(5):520-28. doi: 10.1164/rccm.202106-1350OC..
Keywords: Intensive Care Unit (ICU), Sepsis, Respiratory Conditions, Outcomes
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Iyer AS, Wells JM, Bhatt SP
Life-space mobility and clinical outcomes in COPD.
Social isolation is a common experience in patients with COPD but is not captured by existing patient-reported outcomes, and its association with clinical outcomes is unknown. In this study, the investigators prospectively enrolled adults with stable COPD who completed a series of assessments. They determined associations between Life-Space mobility and clinical outcomes using regression analyses. They found that Restricted Life-Space mobility predicted severe exacerbations and was associated with reduced exercise tolerance, more severe dyspnea, reduced quality of life, and greater depressive symptoms.
AHRQ-funded; HS023009.
Citation: Iyer AS, Wells JM, Bhatt SP .
Life-space mobility and clinical outcomes in COPD.
Int J Chron Obstruct Pulmon Dis 2018 Sep 4;13:2731-38. doi: 10.2147/copd.s170887..
Keywords: Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research
Goto T, Shimada YJ, Faridi MK
Incidence of acute cardiovascular event after acute exacerbation of COPD.
There is a lack of comprehensive view of the association between acute exacerbation of COPD (AECOPD) and the risk of acute cardiovascular events. The purpose of this study was to determine the association of AECOPD with 30-day and 1-year incidences of acute cardiovascular event. The investigators concluded that AECOPD was associated with increased 30-day and 1-year incidences of acute cardiovascular event.
AHRQ-funded; HS023305.
Citation: Goto T, Shimada YJ, Faridi MK .
Incidence of acute cardiovascular event after acute exacerbation of COPD.
J Gen Intern Med 2018 Sep;33(9):1461-68. doi: 10.1007/s11606-018-4518-3.
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Keywords: Respiratory Conditions, Cardiovascular Conditions, Risk, Chronic Conditions, Heart Disease and Health, Outcomes
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Semenkovich TR, Olsen MA, Puri V
Current state of empyema management.
The goal of this study was to examine current treatment practices and outcomes for inpatient treatment of empyema. A comprehensive, longitudinal data set from the New York State Inpatient Database, encompassing an entire state cohort of hospitalized patients, was used. The cohort included 4,095 patients who were undergoing intervention for primary empyema and were discharged 2009 to 2014 with chest tube, video-assisted thoracoscopic surgery (VATS) decortication and drainage, or open drainage and decortication. Patients were categorized into these three groups by definitive treatment during their initial hospitalization. The findings indicate that patients who were managed with chest tubes showed higher readmission and reintervention rates, suggesting that some of these patients may benefit from earlier definitive surgical intervention.
AHRQ-funded; HS019455.
Citation: Semenkovich TR, Olsen MA, Puri V .
Current state of empyema management.
Ann Thorac Surg 2018 Jun;105(6):1589-96. doi: 10.1016/j.athoracsur.2018.02.027..
Keywords: Care Management, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Outcomes, Respiratory Conditions