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
101 to 125 of 162 Research Studies DisplayedCramer JD, Patel UA, Maas MB
Is neck dissection associated with an increased risk of postoperative stroke?
The researchers investigated whether neck dissection is an independent risk factor for postoperative stroke. They found that the rate of postoperative stroke was greater with neck dissection than without it and concluded that stroke is a rare but highly morbid complication after head and neck surgery. Compared with other head and neck surgery, neck dissection in patients at risk for carotid artery stenosis is associated with an increased risk of postoperative stroke.
AHRQ-funded; HS023011.
Citation: Cramer JD, Patel UA, Maas MB .
Is neck dissection associated with an increased risk of postoperative stroke?
Otolaryngol Head Neck Surg 2017 Aug;157(2):226-32. doi: 10.1177/0194599817698414.
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Keywords: Orthopedics, Quality Improvement, Risk, Stroke, Surgery
Sauser Zachrison K, Schwamm LH
Implementation of rapid treatment and interfacility transport for patients with suspected stroke by large-vessel occlusion: in one door and out the other.
This editorial discusses an article in this same issue of JAMA Neurology (McTaggart et al) that describes the results of the implementation of a standard protocol for patients with suspected emergent large-vessel occlusion (ELVO), and the protocol’s impact on both the process of care and patient outcomes. The editorial concludes that the McTaggart article challenges the medical community to develop an interdisciplinary, team-based, protocol-based approach to patients with potential ELVOs, and that work across the disciplines is needed to achieve an acceptable false-positive rate for the system.
AHRQ-funded; HS024561.
Citation: Sauser Zachrison K, Schwamm LH .
Implementation of rapid treatment and interfacility transport for patients with suspected stroke by large-vessel occlusion: in one door and out the other.
JAMA Neurol 2017 Jul;74(7):765-66. doi: 10.1001/jamaneurol.2017.0324..
Keywords: Brain Injury, Health Services Research (HSR), Healthcare Delivery, Stroke, Transitions of Care, Trauma
Krishnan S, Pappadis MR, Weller SC
Needs of stroke survivors as perceived by their caregivers: a scoping review.
Caregivers usually are not involved while planning the stroke survivor's medical and rehabilitation goals and interventions. This review aimed to identify the needs of stroke survivors as perceived by their caregivers. The data synthesis from 66 studies produced the following three metathemes: (a) body functional needs, (b) activity and participatory needs, and (c) environmental needs.
AHRQ-funded; HS022134; HS024711.
Citation: Krishnan S, Pappadis MR, Weller SC .
Needs of stroke survivors as perceived by their caregivers: a scoping review.
Am J Phys Med Rehabil 2017 Jul;96(7):487-505. doi: 10.1097/phm.0000000000000717.
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Keywords: Stroke, Caregiving, Rehabilitation, Cardiovascular Conditions
Lin C, Lee J, Chatterjee N
Predicting domain-specific health-related quality of life using acute infarct volume.
This study evaluated whether acute infarct volume predicts domain-specific Neuro-Quality of Life scores at 3 months after stroke. It found that acute infarct volume is a poor predictor of health-related quality of life (HRQOL) domains after ischemic stroke, with the exception of the cognitive domain. Overall, clinical and imaging variables explained less than 50 percent of the variance in HRQOL outcomes at 3 months.
AHRQ-funded; HS023437.
Citation: Lin C, Lee J, Chatterjee N .
Predicting domain-specific health-related quality of life using acute infarct volume.
Stroke 2017 Jul;48(7):1925-31. doi: 10.1161/strokeaha.117.017094.
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Keywords: Quality of Life, Stroke, Patient-Centered Outcomes Research
Tajeu GS, Mennemeyer S, Menachemi N
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
The researchers compared the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. They concluded that antihypertensive medication treatment is cost-saving and increases quality-adjusted life-years (QALYs) for all groups considered in the model, particularly among black adults.
AHRQ-funded; HS013852.
Citation: Tajeu GS, Mennemeyer S, Menachemi N .
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
Med Care 2017 Jun;55(6):552-60. doi: 10.1097/mlr.0000000000000719.
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Keywords: Medication, Blood Pressure, Healthcare Costs, Racial and Ethnic Minorities, Stroke
Wilson JL, Eriksson CO, Williams CN
Endovascular therapy in pediatric stroke: utilization, patient characteristics, and outcomes.
This study aimed to describe endovascular therapy utilization and explore outcomes in a national sample of pediatric arterial ischemic stroke patients. In this sample of children with a diagnosis of arterial ischemic stroke, endovascular therapy was infrequently utilized. Patients with a procedure code for endovascular therapy had significant stroke-related deficits, but outcomes were similar to those in children who did not receive endovascular therapy.
AHRQ-funded; HS022981.
Citation: Wilson JL, Eriksson CO, Williams CN .
Endovascular therapy in pediatric stroke: utilization, patient characteristics, and outcomes.
Pediatr Neurol 2017 Apr;69:87-92.e2. doi: 10.1016/j.pediatrneurol.2017.01.013.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Stroke
Tam MC, Lee R, Cascino TM
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic hypertension (HTN) and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN.
AHRQ-funded; HS024567.
Citation: Tam MC, Lee R, Cascino TM .
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Curr Hypertens Rep 2017 Feb;19(2):12. doi: 10.1007/s11906-017-0709-2.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Stroke, Outcomes
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
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Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Nakagawa K, Ahn HJ, Taira DA
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
The authors sought to compare potentially preventable readmissions (PPR) among a multiethnic population in Hawaii. They concluded that the Chinese ethnicity may have a higher risk of 30-day PPR after stroke compared to whites. Other associated factors include mental illness, Medicaid, and Hawaii county.
AHRQ-funded; HS019990.
Citation: Nakagawa K, Ahn HJ, Taira DA .
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
Stroke 2016 Oct;47(10):2611-7. doi: 10.1161/strokeaha.116.013669.
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Keywords: Stroke, Racial and Ethnic Minorities, Hospital Readmissions, Hospitalization, Risk
Kabra R, Girotra S, Vaughan Sarrazin M
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
The authors hypothesized that the addition of African-American ethnicity to the CHA2DS2-VASc score might improve stroke prediction in patients with atrial fibrillation (AF). They found that, in patients over age 65 with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score significantly improved stroke prediction.
AHRQ-funded; HS023104.
Citation: Kabra R, Girotra S, Vaughan Sarrazin M .
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
J Am Coll Cardiol 2016 Aug 2;68(5):461-70. doi: 10.1016/j.jacc.2016.05.044.
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Keywords: Stroke, Heart Disease and Health, Racial and Ethnic Minorities, Risk, Cardiovascular Conditions
Lima FO, Silva GS, Furie KL
Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes.
The authors aimed to develop a simple field scale to identify large vessel occlusion strokes (LVOS). They found that Field Assessment Stroke Triage for Emergency Destination (FAST-ED) is a simple scale that, if successfully validated in the field, may be used by medical emergency professionals to identify LVOS in the prehospital setting enabling rapid triage of patients.
AHRQ-funded; HS011392.
Citation: Lima FO, Silva GS, Furie KL .
Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes.
Stroke 2016 Aug;47(8):1997-2002. doi: 10.1161/strokeaha.116.013301.
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Keywords: Care Management, Elderly, Emergency Department, Stroke
Karp DN, Wolff CS, Wiebe DJ
Reassessing the stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States.
The researchers identified clusters of high stroke mortality and adjacent areas of low stroke mortality for US counties and evaluated for regional differences in county-level risk factors. They found that clusters of high stroke mortality exist beyond the 8-state stroke belt, and variation exists within the stroke belt. They recommended reconsideration of the stroke belt definition and suggested increased attention to local determinants of health underlying small area regional variability to inform targeted healthcare interventions.
AHRQ-funded; HS018362.
Citation: Karp DN, Wolff CS, Wiebe DJ .
Reassessing the stroke belt: using small area spatial statistics to identify clusters of high stroke mortality in the United States.
Stroke 2016 Jul;47(7):1939-42. doi: 10.1161/strokeaha.116.012997.
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Keywords: Mortality, Risk, Stroke, Social Determinants of Health
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Hodell E, Hughes SD, Corry M
Paramedic perspectives on barriers to prehospital acute stroke recognition.
The researchers aimed to understand systematically the challenges and barriers faced by paramedics in recognizing stroke presentations in the field. They concluded that while challenges to stroke recognition in the field were slightly different for rural and urban emergency medical service providers, participants concurred that timely, systematic feedback on individual patients and case-based training would strengthen early stroke recognition skills.
AHRQ-funded; HS017965.
Citation: Hodell E, Hughes SD, Corry M .
Paramedic perspectives on barriers to prehospital acute stroke recognition.
Prehosp Emerg Care 2016 May-Jun;20(3):415-24. doi: 10.3109/10903127.2015.1115933.
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Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Healthcare Delivery, Stroke, Training
Brach C
AHRQ Author: Brach C
Even in an emergency, doctors must make informed consent an informed choice.
When a stroke is suspected, a daughter is pressured to consent to her father's treatment without fully understanding the risks.
AHRQ-authored.
Citation: Brach C .
Even in an emergency, doctors must make informed consent an informed choice.
Health Aff 2016 Apr;35(4):739-43. doi: 10.1377/hlthaff.2015.1407.
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Keywords: Case Study, Shared Decision Making, Emergency Department, Health Literacy, Patient and Family Engagement, Stroke
Fonarow GG, Liang L, Thomas L
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
The researchers evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days and at 1 year post event. They concluded that in a population of older patients with ischemic stroke, home-time was readily available from administrative data and associated with mRS at 90 days and 1 year.
AHRQ-funded; HS019479; HS016964.
Citation: Fonarow GG, Liang L, Thomas L .
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
Stroke 2016 Mar;47(3):836-42. doi: 10.1161/strokeaha.115.011599.
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Keywords: Medicare, Stroke, Elderly, Home Healthcare, Patient-Centered Outcomes Research
Lyerly MJ, Wu TC, Mullen MT
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
The authors sought to determine the effect of telemedicine on access to acute stroke care for racial and ethnic minorities in the state of Texas. They found that telemedicine increased access to acute stroke care for 1.5 million Texans, and they found no evidence of disparities in access to the acute stroke expertise afforded by telemedicine.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Wu TC, Mullen MT .
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
J Telemed Telecare 2016 Mar;22(2):114-20. doi: 10.1177/1357633x15589534.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Stroke, Telehealth
Navarro-Millan I, Yang S, DuVall SL
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
The researchers studied the association of serum lipids, inflammation, and seropositivity on coronary heart disease (CHD) and stroke in patients with rheumatoid arthritis. They found that in the study population of predominantly male veterans, higher levels of erythrocyte sedimentation rate and C-reactive protein were associated with increased risk of heart attack and stroke, and higher levels of HDL-C were inversely associated with heart attack and stroke.
AHRQ-funded; HS018517
Citation: Navarro-Millan I, Yang S, DuVall SL .
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
Ann Rheum Dis. 2016 Feb;75(2):341-7. doi: 10.1136/annrheumdis-2013-204987..
Keywords: Stroke, Cardiovascular Conditions, Arthritis
Albright KC, Boehme AK, Tanner RM
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
The authors examined racial differences in risk factors being addressed among stroke survivors and those at risk for stroke. They found that addressed hypertension and hyperlipidemia in stroke-naïve participants were significantly lower in blacks than in whites. They concluded that a better understanding of this information is critical to preventing stroke and other vascular diseases.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Boehme AK, Tanner RM .
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
Ethn Dis 2016 Jan 21;26(1):9-16. doi: 10.18865/ed.26.1.9.
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Keywords: Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Prevention, Stroke
Lewis MW, Khodneva Y, Redmond N
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
The authors investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. They found that, for younger individuals, low income, regardless of education, was associated with higher risk of CHD; however, this was not observed for those 65 years of age or older.
AHRQ-funded; HS023009.
Citation: Lewis MW, Khodneva Y, Redmond N .
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
BMC Public Health 2015 Dec 29;15:1312. doi: 10.1186/s12889-015-2630-4.
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Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Social Determinants of Health, Stroke
Darger B, Gonzales N, Banuelos RC
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
The purpose of this study was to assess safety and efficacy of thrombolysis in the setting of aggressive blood pressure (BP) control as it compares to standard BP control or no BP control prior to thrombolysis. The researchers observed no association between BP control and adverse outcomes in ischemic stroke patients undergoing thrombolysis.
AHRQ-funded; HS017586.
Citation: Darger B, Gonzales N, Banuelos RC .
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
West J Emerg Med 2015 Dec;16(7):1002-6. doi: 10.5811/westjem.2015.8.27859.
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Keywords: Blood Pressure, Stroke, Medication, Outcomes
Kerber KA, Meurer WJ, Brown DL
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
The researchers estimated the ability of bedside information to risk stratify stroke in acute dizziness presentations. They found that in acute dizziness presentations, the combination of ABCD(2) score, general neurologic examination, and a specialized ocular motor examination has the capacity to risk-stratify acute stroke on MRI.
AHRQ-funded; HS018334; HS017690; HS022258.
Citation: Kerber KA, Meurer WJ, Brown DL .
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
Neurology 2015 Nov 24;85(21):1869-78. doi: 10.1212/wnl.0000000000002141..
Keywords: Stroke, Risk, Healthcare Utilization, Shared Decision Making
Yaghi S, Herber C, Willey JZ
Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits.
The researchers' aim was to identify predictors of MRI-positive stroke from the itemized NIHSS. They concluded that NIHSS score subsets predict diffusion-weighted imaging positivity in mild strokes, and the presence of neglect or visual field deficits on the NIHSS subsets is most likely to have an MRI correlate even in patients with low NIHSS.
AHRQ-funded; HS013852.
Citation: Yaghi S, Herber C, Willey JZ .
Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits.
J Neurol Sci 2015 Nov 15;358(1-2):221-5. doi: 10.1016/j.jns.2015.08.1548.
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Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Aparicio HJ, Carr BG, Kasner SE
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
The researechers found that racial disparities in intravenous recombinant tissue plasminogen activator (rt-PA) use were not reduced by presentation to primary stroke centers (PSCs). Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
AHRQ-funded; HS018362; HS017960; HS013852.
Citation: Aparicio HJ, Carr BG, Kasner SE .
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
J Am Heart Assoc 2015 Oct 14;4(10):e001877. doi: 10.1161/jaha.115.001877.
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Keywords: Healthcare Delivery, Disparities, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Stroke
Siegler JE, Samai A, Albright KC
Factoring in factor VIII with acute ischemic stroke.
This review summarized the molecular role of factor VIII in thrombogenesis and its clinical use in the diagnosis and prognosis of acute ischemic stroke. It also discussed the utility of screening for serum factor VIII levels among patients at risk for, or those who have experienced, ischemic stroke.
AHRQ-funded; HS013852.
Citation: Siegler JE, Samai A, Albright KC .
Factoring in factor VIII with acute ischemic stroke.
Clin Appl Thromb Hemost 2015 Oct;21(7):597-602. doi: 10.1177/1076029615571630.
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Keywords: Stroke, Blood Clots, Cardiovascular Conditions