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
1 to 10 of 10 Research Studies DisplayedPannucci CJ, Fleming KI, Varghese TK
Low anti-factor Xa level predicts 90-day symptomatic venous thromboembolism in surgical patients receiving enoxaparin prophylaxis: a pooled analysis of eight clinical trials.
This study examined whether low anti-factor Xa (aFXa) level predicts 90-day symptomatic venous thromboembolism (VTE) in surgical patients receiving enoxaparin prophylaxis. The authors conducted a pooled analysis of 8 clinical trials from a single institution over a 4-year period. Among 985 patients, 2.3% had symptomatic 90-day VTE, 4.2% had 90-day clinically relevant bleeding, and 2.1% had major bleeding. Patients with initial low aFXa were significantly more likely to have 90-day VTE than patients with adequate or high xFXa (4.2% vs 1.3%). This relationship was significant for patients who received enoxaparin twice daily as opposed to once a day. No association was seen between high xFXa and 90-day clinically relevant bleeding or major bleeding.
AHRQ-funded; HS024326.
Citation: Pannucci CJ, Fleming KI, Varghese TK .
Low anti-factor Xa level predicts 90-day symptomatic venous thromboembolism in surgical patients receiving enoxaparin prophylaxis: a pooled analysis of eight clinical trials.
Ann Surg 2022 Dec 1;276(6):e682-e90. doi: 10.1097/sla.0000000000004589..
Keywords: Blood Thinners, Surgery, Medication, Blood Clots
Shi J, Hurdle JF, Johnson SA
Natural language processing for the surveillance of postoperative venous thromboembolism.
The objective of the study was to develop a portal natural language processing approach to aid in the identification of postoperative venous thromboembolism events from free-text clinical notes. The investigators concluded that accurate surveillance of postoperative venous thromboembolism may be achieved using natural language processing on clinical notes in 2 independent health care systems. They indicated that these findings suggest natural language processing may augment manual chart abstraction for large registries such as National Surgical Quality Improvement Program.
AHRQ-funded; HS025776.
Citation: Shi J, Hurdle JF, Johnson SA .
Natural language processing for the surveillance of postoperative venous thromboembolism.
Surgery 2021 Oct;170(4):1175-82. doi: 10.1016/j.surg.2021.04.027..
Keywords: Blood Clots, Health Information Technology (HIT), Quality Improvement, Quality of Care, Surgery, Adverse Events
Khorfan R, Kreutzer L, Love R
Association between missed doses of chemoprophylaxis and VTE incidence in a statewide colectomy cohort.
The objectives of this study were to assess the incidence of missed doses of inpatient venous thromboembolism (VTE) chemoprophylaxis after colectomy in a statewide patient cohort and to examine the association between missed chemoprophylaxis doses and postoperative VTE. Findings showed that 13% of post-colectomy inpatients did not receive all prescribed doses of inpatient VTE chemoprophylaxis, and at least 1 missed dose of chemoprophylaxis was associated with an over twofold increased incidence of VTE among patients at high risk for VTE. Recommendations included verifying that patients receive all prescribed doses, identifying why doses are missed, and instituting quality improvement efforts to ensure patients receive all appropriate doses.
AHRQ-funded; HS024516.
Citation: Khorfan R, Kreutzer L, Love R .
Association between missed doses of chemoprophylaxis and VTE incidence in a statewide colectomy cohort.
Ann Surg 2021 Apr;273(4):e151-e52. doi: 10.1097/sla.0000000000004349..
Keywords: Blood Clots, Adverse Events, Surgery
Schlick CJR, Yuce TK, Yang AD
A postdischarge venous thromboembolism risk calculator for inflammatory bowel disease surgery.
Guidelines recommend extended chemoprophylaxis for venous thromboembolism in high-risk patients having operations for inflammatory bowel disease. Quantifying patients' risk of venous thromboembolism, however, remains challenging. In this study, the investigators sought (1) to identify factors associated with postdischarge venous thromboembolism in patients undergoing colorectal resection for inflammatory bowel disease and (2) to develop a postdischarge venous thromboembolism risk calculator to guide prescribing of extended chemoprophylaxis.
AHRQ-funded; HS024516; HS000078; HS026385.
Citation: Schlick CJR, Yuce TK, Yang AD .
A postdischarge venous thromboembolism risk calculator for inflammatory bowel disease surgery.
Surgery 2021 Feb;169(2):240-47. doi: 10.1016/j.surg.2020.09.006..
Keywords: Blood Clots, Adverse Events, Patient Safety, Surgery, Risk
Schlick CJR, Merkow RP, Yang AD
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
Extended chemoprophylaxis is recommended for high-risk patients following pancreatectomy for malignancy. However, quantifying risk remains difficult. In this study, the investigators sought to (a) identify factors associated with post-discharge venous thromboembolism (VTE) following pancreatectomy for malignancy and (b) develop a post-discharge VTE risk calculator to identify high-risk patients. The investigators concluded that preoperative, intraoperative, and postoperative factors were associated with post-discharge VTE following pancreatectomy for malignancy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Merkow RP, Yang AD .
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
J Surg Oncol 2020 Sep 15;122(4):675-83. doi: 10.1002/jso.26046..
Keywords: Cancer, Surgery, Treatments, Blood Clots, Risk
de Meireles A, Carlin AM, Cain-Nielsen A
Association between surgeon practice knowledge and venous thromboembolism.
Venous thromboembolism (VTE) is the most common cause of mortality following bariatric surgery. This study aimed to determine practice patterns of VTE chemoprophylaxis among bariatric surgeons participating in a large statewide quality collaborative and compare the results of surgeon self-reported chemoprophylaxis prescription practices versus actual data from abstracted charts. They administered a 13-question survey to 66 surgeons to reveal VTE practice patterns such as medication type, dosage, timing, duration, and level of trainee involvement. They also examined the charts of all patients who had developed VTE during the study period and 15 other randomly selected patient charts per site. There was found to be a greater discordance between surgeon self-reported and actual perioperative VTE prophylaxis, but there was no significant discordance postoperatively. Greater perioperative discordance is associated with significantly increased risk of VTE.
AHRQ-funded; HS02362; HS024403.
Citation: de Meireles A, Carlin AM, Cain-Nielsen A .
Association between surgeon practice knowledge and venous thromboembolism.
Obes Surg 2020 Feb 16;30(6):2274-79. doi: 10.1007/s11695-020-04468-6..
Keywords: Surgery, Obesity: Weight Management, Obesity, Blood Clots, Practice Patterns, Provider: Physician, Provider
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation: Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Decision Making, Medication
Murphy PB, Vogt KN, Lau BD
Venous thromboembolism prevention in emergency general surgery: a review.
Operatively and nonoperatively treated emergency general surgery patients are at a comparatively high risk of venous thromboembolism (VTE). This review found that, despite gaps in existing literature with respect to this increasing patient population, successful best practices can be applied. Best practices include assessment of VTE risk, optimal prophylaxis, and physician, nurse, and patient education regarding the use of mechanical and pharmacologic VTE prophylaxis and institutional policies.
AHRQ-funded; HS024547.
Citation: Murphy PB, Vogt KN, Lau BD .
Venous thromboembolism prevention in emergency general surgery: a review.
JAMA Surg 2018 May;153(5):479-86. doi: 10.1001/jamasurg.2018.0015..
Keywords: Blood Clots, Surgery, Emergency Department, Adverse Events, Prevention, Patient Safety
Cramer JD, Dilger AE, Schneider A
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
Researchers examined the rate of venous thromboembolism (VTE) for various otolaryngology procedures compared with an established average-risk field and low-risk field. They identified a high-risk group for VTE in otolaryngology; however, they found that most patients undergoing otolaryngology procedures are at low risk of VTE, indicating that guidelines for a low-risk population could be adapted to otolaryngology. The authors concluded that patients undergoing high-risk otolaryngology procedures should be considered as candidates for more aggressive VTE prophylaxis.
AHRQ-funded; HS023011.
Citation: Cramer JD, Dilger AE, Schneider A .
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
JAMA Otolaryngol Head Neck Surg 2018 Jan;144(1):9-17. doi: 10.1001/jamaoto.2017.1768..
Keywords: Surgery, Blood Clots, Risk, Adverse Events, Patient Safety