National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Behavioral Health (1)
- Blood Thinners (1)
- Cancer (1)
- Cardiovascular Conditions (23)
- Children/Adolescents (1)
- Chronic Conditions (5)
- Clinical Decision Support (CDS) (2)
- Depression (2)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Elderly (6)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Health Information Technology (HIT) (2)
- Health Status (1)
- (-) Heart Disease and Health (23)
- Hospitalization (4)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Medical Devices (2)
- Medicare (3)
- Medication (2)
- Mortality (6)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Safety (1)
- Prevention (2)
- Provider: Clinician (1)
- Registries (1)
- Rehabilitation (1)
- Respiratory Conditions (1)
- (-) Risk (23)
- Shared Decision Making (3)
- Stroke (3)
- Surgery (3)
- Transitions of Care (1)
- Transplantation (1)
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 23 of 23 Research Studies DisplayedGallo T, Heise CW, Woosley RL
Clinician satisfaction with advanced clinical decision support to reduce the risk of torsades de pointes.
The purpose of this study was to create an advanced torsades de pointes (TdP) clinical decision support (CDS) advisory that provides relevant, patient-specific information, including 1-click management options, and to evaluate clinician satisfaction with the CDS. The researchers implemented the advanced TdP CDS across a health system comprising 29 hospitals. A brief electronic survey was developed to collect clinician feedback on the advisory and was emailed to 442 clinicians who received the advisory. Feedback was generally positive across the 38 responding providers, with 79% of respondents reporting that the advisory assisted with their care for their patients and 87% responding that the alerts clearly specified alternative actions. The researchers concluded that providers who receive an advanced TdP risk CDS alert generally view the alert favorably.
AHRQ-funded; HS026662.
Citation: Gallo T, Heise CW, Woosley RL .
Clinician satisfaction with advanced clinical decision support to reduce the risk of torsades de pointes.
J Patient Saf 2022 Sep 1;18(6):e1010-e13. doi: 10.1097/pts.0000000000000996..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Risk, Provider: Clinician, Heart Disease and Health, Cardiovascular Conditions
Khodneva Y, Goyal P, Levitan EB
Depressive symptoms and incident hospitalization for heart failure: findings From the REGARDS Study.
The purpose of this study was to determine whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with preserved (HFpEF) or reduced ejection fraction (HFrEF). The study found that over a median of 9.2 years of follow-up, there were 872 incident HF hospitalizations, 526 among those without CHD and 334 among those with CHD. The age-adjusted HF hospitalization incidence rates per 1000 person-years were 4.9 for participants with depressive symptoms compared with 3.2 for participants without depressive symptoms. For overall HF, the elevated risk lessened after controlling for covariates. Among those without baseline CHD, when HFpEF was evaluated separately, after controlling for all covariates, depressive symptoms were related with incident hospitalization. In contrast, depressive symptoms were not related with incident HFrEF hospitalizations. The researchers concluded that among individuals without CHD at baseline, depressive symptoms were related with incident hospitalization for HFpEF, but not for those with baseline CHD or HFrEF.
AHRQ-funded; HS013852.
Citation: Khodneva Y, Goyal P, Levitan EB .
Depressive symptoms and incident hospitalization for heart failure: findings From the REGARDS Study.
J Am Heart Assoc 2022 Apr 5;11(7):e022818. doi: 10.1161/jaha.121.022818..
Keywords: Depression, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk
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
Bavishi A, Bruce M, Ning H
Predictive accuracy of heart failure-specific risk equations in an electronic health record-based cohort.
The objective of this study was to assess the predictive accuracy of the Pooled Cohort Equations to Prevent Heart Failure within a primary prevention cohort derived from the electronic health record. Findings showed that a novel sex- and race-specific risk score predicts incident heart failure (HF) in a real-world, electronic health record-based cohort. Recommendations included integration of HF risk into the electronic health record to allow for risk-based discussion, enhanced surveillance, and targeted preventive interventions in order to reduce the public health burden of HF.
AHRQ-funded; HS026385.
Citation: Bavishi A, Bruce M, Ning H .
Predictive accuracy of heart failure-specific risk equations in an electronic health record-based cohort.
Circ Heart Fail 2020 Nov;13(11):e007462. doi: 10.1161/circheartfailure.120.007462..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention, Risk
Wehbe RM, Khan SS, Shah SJ
Predicting high-risk patients and high-risk outcomes in heart failure.
Identifying patients with heart failure at high risk for poor outcomes is important for patient care, resource allocation, and process improvement. Although numerous risk models exist to predict mortality, hospitalization, and patient-reported health status, they are infrequently used for several reasons, including modest performance, lack of evidence to support routine clinical use, and barriers to implementation. The authors discuss the potential of artificial to enhance the performance of risk prediction models.
AHRQ-funded; HS026385.
Citation: Wehbe RM, Khan SS, Shah SJ .
Predicting high-risk patients and high-risk outcomes in heart failure.
Heart Fail Clin 2020 Oct;16(4):387-407. doi: 10.1016/j.hfc.2020.05.002..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Hospitalization
Khera R, Kondamudi N, Zhong L
Temporal trends in heart failure incidence among Medicare
This retrospective, national cohort study looked at temporal trends in heart failure (HF) incidence among Medicare beneficiaries from 2011 to 2016. There had been a decline in claims during that time period. Five percent of all fee-for-service Medicare beneficiaries with no prior HF diagnosis were followed up from 2011-2016. Annual trends were examined in HF incidence among groups with and without primary HF risk factors (hypertension, diabetes, and obesity) and predisposing cardiovascular conditions (acute myocardial infarction (MI) and atrial fibrillation (AF). Of the approximately 1.8 million Medicare beneficiaries at risk for HF, 249,832 had a new diagnosis of HF. The prevalence of all 5 risk factors had increased during the 5-year study period. There was a relative decline in HF incidence among beneficiaries with primary HF risk factors, but incidence increased among individuals with acute MI and AF.
AHRQ-funded; HS022418.
Citation: Khera R, Kondamudi N, Zhong L .
Temporal trends in heart failure incidence among Medicare
JAMA Netw Open 2020 Oct;3(10):e2022190. doi: 10.1001/jamanetworkopen.2020.22190.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Medicare, Risk, Elderly, Mortality
O'Halloran JA, Sahrmann J, Butler AM
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
AHRQ-funded; HS019455.
Citation: O'Halloran JA, Sahrmann J, Butler AM .
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
J Acquir Immune Defic Syndr 2020 Aug 1;84(4):396-99. doi: 10.1097/qai.0000000000002357..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Medication, Stroke, Heart Disease and Health, Risk
Prasada S, Rivera A, Nishtala A
Differential associations of chronic inflammatory diseases with incident heart failure.
The purpose of this study was to compare the risks of incident heart failure (HF) among a variety of chronic inflammatory diseases (CIDs) and to determine whether risks varied by severity of inflammation within each CID. Electronic health records from a large urban medical system were examined. Findings showed that systemic sclerosis and systemic lupus erythematosus were associated with the highest risks of HF, followed by rheumatoid arthritis and HIV. Measurements of inflammation were associated with HF risk across different CIDs.
AHRQ-funded; HS026385.
Citation: Prasada S, Rivera A, Nishtala A .
Differential associations of chronic inflammatory diseases with incident heart failure.
JACC Heart Fail 2020 Jun;8(6):489-98. doi: 10.1016/j.jchf.2019.11.013..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk
Angraal S, Mortazavi BJ, Gupta A
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
This study developed models to predict the risk of death and hospitalization in patients with heart failure (HF) with preserved ejection fraction (HFpEF). Data was used from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) clinical trial. Five methods: logistic regression with a forward selection of variables; logistic regression with a lasso regularization for variable selection; random forest (RF); gradient descent boosting; and support vector machine, were used to train models for assessing risks of mortality and HF hospitalization through 3 years of follow-up and were validated using 5-fold cross-validation. RF was found to be the best performing model for predicting mortality and HF hospitalization. Blood urea nitrogen levels, body mass index, and Kansas City Cardiomyopathy Questionnaire (KCCQ) subscale scores were strongly associated with mortality, while hemoglobin level, blood urea nitrogen, time since previous HF hospitalization, and KCCQ scores were the most significant predictors of HF hospitalization.
AHRQ-funded; HS023000.
Citation: Angraal S, Mortazavi BJ, Gupta A .
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
JACC Heart Fail 2020 Jan;8(1):12-21. doi: 10.1016/j.jchf.2019.06.013..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Mortality, Hospitalization, Risk, Health Status, Health Information Technology (HIT)
Patel 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
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Kundi H, Popma JJ, Valsdottir LR
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
The goals of this study were to identify nontraditional risk factors coded in administrative claims data and to evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair. Patients undergoing transcatheter mitral valve repair using MitraClip implantation were identified among Medicare fee-for-service beneficiaries; researchers used nested Cox regression models to identify claims codes predictive of long-term mortality. Four groups of variables were introduced: cardiac, noncardiac, and nontraditional risk factors, and presentation characteristics. The authors conclude that risk-prediction models, which include nontraditional risk factors as identified in claims data, can be used to predict long-term mortality risk more accurately in patients who have undergone MitraClip procedures.
AHRQ-funded; HS024520.
Citation: Kundi H, Popma JJ, Valsdottir LR .
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
Can J Cardiol 2018 Dec;34(12):1648-54. doi: 10.1016/j.cjca.2018.10.002..
Keywords: Cardiovascular Conditions, Elderly, Mortality, Heart Disease and Health, Medicare, Risk, Surgery
Reeder HT, Shen C, Buxton AE
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
This study’s goal was to develop a joint shock/death risk prediction tool for patients who received implantable cardioverter-defibrillators (ICDs). Secondary analysis of patients was conducted as part of the SCD-HeFT trial (Sudden Cardiac Death in Heart Failure Trial). An illness-death regression model was applied for both ICD shocks and deaths. Among 803 ICD recipients, 430 (53.5%) did not receive an ICD shock or die, 206 (25.7%) received at least 1 shock but did not die, 113 (14.1%) died before receiving a shock, and 54 (6.7%) received at least 1 shock but still died. This predictive performance can be used as a tool for individualized counseling for patients contemplating an ICD.
AHRQ-funded; HS024520.
Citation: Reeder HT, Shen C, Buxton AE .
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
Circ Cardiovasc Qual Outcomes 2019 Aug;12(8):e005675. doi: 10.1161/circoutcomes.119.005675..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Risk, Shared Decision Making, Mortality
Mentias A, Shantha G, Adeola O
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
This study examined the role of diabetes and insulin use in the risk of stroke and acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). A cohort of Medicare beneficiaries newly diagnoses with AF from 2011 to 2013 were identified. The cohort was divided into those with diabetes requiring insulin (6.7%), those with diabetes not requiring insulin (31.3%) and non-diabetics (62%). Diabetics requiring insulin were at the greatest risk of stroke and AMI, and diabetics not requiring insulin were at slightly lower risk, but non-diabetics had the lowest risk.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Adeola O .
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
Am Heart J 2019 Aug;214:158-66. doi: 10.1016/j.ahj.2019.05.003..
Keywords: Diabetes, Stroke, Heart Disease and Health, Cardiovascular Conditions, Risk, Chronic Conditions, Elderly
Hajduk AM, Gurwitz JH, Tabada G
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
Researchers sought to determine whether burden of multiple chronic conditions (MCCs) influences the risk of receiving inappropriate vs appropriate device therapies. They studied adults with left ventricular systolic dysfunction receiving an implantable cardioverter-defibrillator (ICD) for primary prevention. In these patients, they found that MCC burden was independently associated with an increased risk of inappropriate but not appropriate device therapies. They recommended considering comorbidity burden when engaging patients in shared decision making about ICD implantation.
AHRQ-funded; 290050033.
Citation: Hajduk AM, Gurwitz JH, Tabada G .
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
J Am Geriatr Soc 2019 Jul;67(7):1370-78. doi: 10.1111/jgs.15839..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Chronic Conditions, Medical Devices, Prevention, Elderly, Risk, Patient-Centered Outcomes Research
Pang PS, Fermann GJ, Hunter BR
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
This study examined the use of high-sensitivity troponin assays to determine whether a patient presenting in the emergency department with chest pains is safe for discharge. An observational study called High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) explored whether serial high-sensitivity troponin (hsTnT) might aid in making diagnosis of acute heart failure faster. The presence of hsTnT above the 99th percentile usually indicates acute heart failure. Patients in the cohort with hsTnT at or above the 99th percentile were older, more often male, less often black, and more likely to have chronic kidney disease. The study found no difference in risk for 90-day death or rehospitalization or return ED visits in the group with hsTnT above the 99th percentile than those with levels below the 99th percentile so hsTnT would not be considered useful.
AHRQ-funded; HS025411.
Citation: Pang PS, Fermann GJ, Hunter BR .
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
Circ Heart Fail 2019 Jul;12(7):e005931. doi: 10.1161/circheartfailure.119.005931..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Emergency Department, Risk, Shared Decision Making
Mentias A, Briasoulis A, Shantha G
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Differential impact of heart failure (HF) category on thromboembolic and bleeding risk in atrial fibrillation (AF) patients on oral anticoagulation (OAC) is unknown. In this study, the investigators used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The investigators concluded that in AF patients, HFrEF and HFpEF are both associated with higher risk of ischemic stroke, HF and AMI admissions, even after adjusting for OAC use, compared with patients without HF.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Shantha G .
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Am J Cardiol 2019 May 15;123(10):1649-53. doi: 10.1016/j.amjcard.2019.02.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Elderly, Patient-Centered Healthcare, Registries
Sharma A, Sun JL, Lokhnygina Y
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
The authors of this article performed a hierarchical cluster analysis to identify acute coronary syndrome (ACS) patients at high risk for adverse clinical events. Post-ACS patients were randomized to ezetimibe+simvastatin or placebo+simvastatin. Ezetimibe's impact on outcomes across clusters; the ability of the cluster analysis to discriminate for outcomes was compared with the Global Registry of Acute Coronary Events (GRACE) score. Outcomes included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina, or coronary revascularization at least 30 days after randomization. Compared with GRACE, cluster analysis did not provide superior outcome discrimination. Consistent ezetimibe treatment effect was identified across clusters. The authors conclude that cluster analysis identified significant difference in risk of outcomes across cluster groups.
AHRQ-funded; HS023000.
Citation: Sharma A, Sun JL, Lokhnygina Y .
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
Am J Cardiol 2019 Apr 15;123(8):1193-201. doi: 10.1016/j.amjcard.2019.01.034..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Outcomes, Patient-Centered Outcomes Research, Risk
Dunn T, Saeed MJ, Shpigel A
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
This study examined whether the use of preoperative cardiac stress testing of patients undergoing kidney transplantation reduced 30-day- death and myocardial infarction post-transplantation. ESRD patients 40 years or older with primary Medicare insurance between 2006 and 2013 were identified using the United States Renal Data System. In a matched cohort of 17,304 patients, there was little difference in 30-day post-transplantation mortality and myocardial infarction between those receiving a stress test and those who did not.
AHRQ-funded; HS019455.
Citation: Dunn T, Saeed MJ, Shpigel A .
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
PLoS One 2019 Feb;14(2):e0211161. doi: 10.1371/journal.pone.0211161..
Keywords: Transplantation, Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Surgery
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Mokhateb-Rafii T, Bakar A, Gangadharan S
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
The objective of this study was to determine a level of oxygen desaturation associated with increased risk of tracheal intubation events in children in a pediatric or cardiac ICU with cyanotic and noncyanotic heart disease. Oxygen desaturation was measured by a fall in pulse oximetry from baseline after pre-oxygenation. The primary outcome was occurrence of hemodynamic tracheal intubation associated events defined as cardiac arrest, hypotension, or dysrhythmia. Results indicate that oxygen desaturation by 30% or more is associated with increased odds for adverse hemodynamic events, after adjusting for confounders. Oxygen desaturation was observed more often in children with cyanotic than those with noncyanotic heart disease, but hemodynamic tracheal intubation associated event rates were similar.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Mokhateb-Rafii T, Bakar A, Gangadharan S .
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
Pediatr Crit Care Med 2019 Jan;20(1):19-26. doi: 10.1097/pcc.0000000000001766..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Heart Disease and Health, Respiratory Conditions, Intensive Care Unit (ICU), Patient Safety, Risk
O'Brien EC, Holmes DN, Thomas L
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
This study investigated whether renal function predicted stroke in patients diagnosed with atrial fibrillation (AF). Data from the Outcomes Registry for Better Informed Treatment (ORBIT-AF) was used. Investigators concluded that renal dysfunction was not independently associated with embolic risk in either treated or untreated patients.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Holmes DN, Thomas L .
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
Int J Cardiol 2019 Jan 1;274:152-57. doi: 10.1016/j.ijcard.2018.07.113..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Stroke