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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 141 Research Studies Displayed
Yan Z, Nielsen V, Song G
Integration of regional hospitalizations, registry and vital statistics data for development of a single statewide ischemic stroke database.
The scope of population-based studies is often limited because databases rarely include detailed clinical variables and vital statistics such as death rates. The study team demonstrated a comprehensive process for integrating three clinical variable, vital statistics, and hospitalization databases into one single, statewide, ischemic stroke database. Using databases spanning 2007-2017, the authors identified and validated linkages between stroke admissions in a hospitalization database (47,713 admissions) and admissions in the stroke registry (43,487 admissions), resulting in 38,493 linked cases (80.7% of total cases) of which 95% were validated. Of the 38,493 linked cases, the authors linked 10,660 to deaths from the vital statistics database, resulting in a comprehensive assessment of cumulative mortality from ischemic strokes over a 7-year period among all registry-linked ischemic stroke hospitalization records. The authors concluded that comprehensive, accurate integration of the clinical registry, statewide hospitalizations, and vital statistics databases is achievable, and may have value for outcomes research on a larger scale.
AHRQ-funded; HS024561.
Citation:
Yan Z, Nielsen V, Song G .
Integration of regional hospitalizations, registry and vital statistics data for development of a single statewide ischemic stroke database.
J Stroke Cerebrovasc Dis 2022 Mar;31(3):106236. doi: 10.1016/j.jstrokecerebrovasdis.2021.106236..
Keywords:
Stroke, Cardiovascular Conditions, Registries
de Loizaga SR, Schneider K, Beck AF
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
In a retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative, researchers investigated the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. They found that community deprivation was associated with mortality and length of stay for patients with single ventricle congenital heart disease. While patients near the mean deprivation index had a higher hazard of one year mortality compared to those at the extremes of the deprivation index, length of stay and deprivation index were linearly associated, demonstrating the complex nature of socioeconomic factors.
AHRQ-funded; HS021114.
Citation:
de Loizaga SR, Schneider K, Beck AF .
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
Pediatr Cardiol 2022 Mar;43(3):605-15. doi: 10.1007/s00246-021-02763-2..
Keywords:
Children/Adolescents, Social Determinants of Health, Quality Improvement, Quality of Care, Cardiovascular Conditions, Registries, Outcomes
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation:
Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords:
Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Roberson ML, Nichols HB, Wheeler
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Surgery is an important part of early stage breast cancer treatment that affects overall survival. Statewide cancer registries contain data on first course of cancer treatment for all patients diagnosed with cancer but the accuracy of these data are uncertain. In this study, the authors examined validity of breast cancer surgery treatment information in a state-based cancer registry.
AHRQ-funded; HS027299.
Citation:
Roberson ML, Nichols HB, Wheeler .
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Cancer Causes Control 2022 Feb;33(2):261-69. doi: 10.1007/s10552-021-01520-3..
Keywords:
Cancer: Breast Cancer, Cancer, Surgery, Registries
Brei BK, Sawyer T, Umoren R
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
This study looked at whether the presence of family members had an impact on neonatal tracheal intubation (TI) outcomes. This retrospective analysis looked at TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS) at 13 academic NICUS from October 2014 to December 2017. Family members were present in less than 10% of TIs, but this varied by site. Success rates were not significantly different, with the first attempt success rate at 55% with family present versus 49% and success within 2 attempts was 74% versus 66%. Adverse TI-associated events (TIAEs) were 17% versus 20% and severe oxygen desaturation was 49% versus 52%. No independent association between any of these outcomes was found with family presence.
AHRQ-funded; HS027259; HS024511.
Citation:
Brei BK, Sawyer T, Umoren R .
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
Arch Dis Child Fetal Neonatal Ed 2021 Jul;106(4):392-97. doi: 10.1136/archdischild-2020-319709..
Keywords:
Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Registries, Patient Safety
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation:
Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords:
Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation:
McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords:
Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Decision Making
Axley J, Novak Z, Blakeslee-Carter J
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
This retrospective cohort study was performed using data on elective vascular surgery procedures and evaluated long-term trends in post-operative myocardial infarction (POMI) using Vascular Surgery Vascular Quality Initiative (VQI) registry data for patients undergoing carotid endarterectomy (CEA), thoracic endovascular aortic repair (TEVAR), endovascular aortic repair (EVAR), open abdominal aortic aneurysm repair (oAAA), suprainguinal bypass (SIB), and infrainguinal bypass (IIB). A total of 227,837 elective procedures were identified. The overall rate of POMI was 1.3% across all procedures. POMI rates from 2003-05 to 2015-17 for CEA decreased from 0.9% to 0.7%, EVAR from 2% to 7%, IIB from 3.8% to 2.4%, and oAAA from 6.8% to 5.1%. From 2009 to 2017 SIB decreased from 3.06% to 2.95%. However, TEVAR increased from 2.4% to 3.56% for the period 2006 to 2017. CEA, EVAR, IIB, oAAA all showed a significant increase in postoperative statin use.
AHRQ-funded; HS013852.
Citation:
Axley J, Novak Z, Blakeslee-Carter J .
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
Ann Vasc Surg 2021 Feb;71:19-28. doi: 10.1016/j.avsg.2020.09.006..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Surgery, Adverse Events, Registries
Branca A, Tellez D, Berkenbosch J
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Researchers evaluated the effect of the timing of the PICU fellow academic cycle on tracheal intubation-associated events in a retrospective cohort study of 37 PICUs participating in the National Emergency Airway Registry for Children.. They found that the New Trainee Effect in tracheal intubation safety outcomes was not observed in various types of PICUs. There was a significant improvement in pediatric critical care medicine fellows' first attempt success and a significant decline in tracheal intubation-associated event rates, indicating substantial skills acquisition throughout pediatric critical care medicine fellowship.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation:
Branca A, Tellez D, Berkenbosch J .
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2020 Dec;21(12):1042-50. doi: 10.1097/pcc.0000000000002480..
Keywords:
Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Registries, Education: Continuing Medical Education, Training
Mohr NM, Pape SG, Runde D
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
The objectives of this study were to describe the current use of etomidate and other induction agents in patients with sepsis and to compare adverse events between etomidate and ketamine in sepsis. Using the National Emergency Airway Registry data set, findings showed that etomidate is used less frequently in sepsis patients than in non-sepsis patients, with ketamine being the most frequently used alternative. Further, ketamine was associated with more postprocedural hypotension than etomidate. Recommendations included future clinical trials to determine the optimal induction agent in patients with sepsis.
AHRQ-funded; HS025753.
Citation:
Mohr NM, Pape SG, Runde D .
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
Acad Emerg Med 2020 Nov;27(11):1140-49. doi: 10.1111/acem.14070..
Keywords:
Medication, Sepsis, Emergency Department, Registries, Adverse Drug Events (ADE), Adverse Events
Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs. The investigators found that RTs infrequently intubated in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation:
Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA .
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Respir Care 2020 Oct;65(10):1534-40. doi: 10.4187/respcare.07667..
Keywords:
Children/Adolescents, Respiratory Conditions, Intensive Care Unit (ICU), Registries, Critical Care
O'Neil ME, Harik JM, McDonagh MS
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
This paper describes the development of a posttraumatic stress disorder (PTSD) repository of randomized controlled trials that will be publicly available for clinical, research, and policy stakeholders. The authors created a preliminary dataset which is maintained by the National Center for PTSD (NCPTSD). They searched multiple databases for studies published 1980 to 2018. A total of 318 RCTS of PTSD interventions that enrolled almost 25,000 participants were included. They abstracted 337 variables across all studies. This paper describes their methods, defines data elements, and explains coding challenges. The data is now publicly available on the NCPTSD website.
AHRQ-funded; 290201500009I.
Citation:
O'Neil ME, Harik JM, McDonagh MS .
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
J Trauma Stress 2020 Aug;33(4):410-19. doi: 10.1002/jts.22520..
Keywords:
Behavioral Health, Research Methodologies, Registries
Jackson LR, Kim S, Blanco R
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
The objective of this study was to evaluate discontinuation rates among patients on warfarin and direct oral anticoagulants (DOACs) in clinical practice. Over 10,000 AF patients were enrolled from the ORBIT-AF II Registry as subjects. Findings showed that, in a community based atrial fibrillation cohort, adjusted rates of discontinuation at 12 months were higher in DOAC-treated versus vitamin K antagonist-treated patients. Discontinuation of oral anticoagulation was associated with increased absolute risk of all-cause mortality and cardiovascular death.
AHRQ-funded; HS021092.
Citation:
Jackson LR, Kim S, Blanco R .
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
Am Heart J 2020 Aug;226:85-93. doi: 10.1016/j.ahj.2020.04.016..
Keywords:
Blood Thinners, Medication, Registries, Stroke, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation:
Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords:
Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Gliklich RE, Leavy MB, Cosgrove L
Harmonized outcome measures for use in depression patient registries and clinical practice.
This project’s goal was to develop a minimum set of standardized outcome measures relevant to both patients and clinicians that can be collected in depression registries and clinical practice. A multi-stakeholder panel categorized the 27 identified measures using AHRQ's supported Outcome Measures Framework. The panel then identified 10 broadly relevant measures and harmonized definitions for these measures. These harmonized measures represent a minimum set of outcomes that are relevant to clinicians and patients and appropriate for use in depression research and clinical practice.
AHRQ-authored; AHRQ-funded; 290201400004C.
Citation:
Gliklich RE, Leavy MB, Cosgrove L .
Harmonized outcome measures for use in depression patient registries and clinical practice.
Ann Intern Med 2020 Jun 16;172(12):803-09. doi: 10.7326/m19-3818..
Keywords:
Registries, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Hansen JE, Brown DW, Hanke SP
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
This study examined trends in the routine use of angiotension-converting enzyme inhibitors (ACEI) during palliation of hypoplastic left heart syndrome, which is considered controversial. The authors used patients enrolled in the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry from 2008 to 2016 who had been prescribed ACEI between stage 1 palliation (stage I Norwood procedure) discharge and stage 2 palliation (stage II superior cavopulmonary anastomosis procedure) admission. ACEI prescriptions declined from 45% in the pre-2010 period to 36.8% from 2011 to 2016. No difference was found in interstage mortality, change in atrioventricular valve regurgitation, or change in ventricular dysfunction between groups. Atrioventricular septal defect, and preoperative mechanical ventilation were associated with increased ACEI prescription.
AHRQ-funded; HS021114.
Citation:
Hansen JE, Brown DW, Hanke SP .
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
J Am Heart Assoc 2020 May 18;9(10):e014823. doi: 10.1161/jaha.119.014823..
Keywords:
Newborns/Infants, Medication, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Registries, Quality Improvement, Quality of Care
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation:
Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords:
Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Laughlin-Tommaso SK, Lu D, Thomas L
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Investigators compared women's perception of their short-term health-related quality of life measures and reported time to return to usual activities and return to work for different routes of myomectomy. Using data from the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry, and including abdominal and laparoscopic myomectomy procedures, they found that women who underwent myomectomy had substantial improvement in health-related quality of life, regardless of route of myomectomy; abdominal myomectomy was associated with a nearly 2-week longer time to return to work than laparoscopic myomectomy.
AHRQ-funded; HS023418.
Citation:
Laughlin-Tommaso SK, Lu D, Thomas L .
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Am J Obstet Gynecol 2020 Apr;222(4):345.e1-45.e22. doi: 10.1016/j.ajog.2019.09.052..
Keywords:
Quality of Life, Women, Surgery, Patient-Centered Outcomes Research, Registries
Muzaale AD, Massie AB, Al Ammary F
Donor-recipient relationship and risk of ESKD in live kidney donors of varied racial groups.
Risk factors for kidney failure are the basis of live kidney donor candidate evaluation. In this retrospective cohort study, the investigators quantified risk for end-stage kidney disease (ESKD) by the biological relationship of the donor to the recipient, a risk factor that is not addressed by current clinical practice guidelines. The investigators found that marked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors.
AHRQ-funded; HS024600.
Citation:
Muzaale AD, Massie AB, Al Ammary F .
Donor-recipient relationship and risk of ESKD in live kidney donors of varied racial groups.
Am J Kidney Dis 2020 Mar;75(3):333-41. doi: 10.1053/j.ajkd.2019.08.020..
Keywords:
Transplantation, Kidney Disease and Health, Racial / Ethnic Minorities, Risk, Registries
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation:
Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords:
Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation:
Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords:
Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Dhruva, SS, Parzynski CS, Gamble GM
Attribution of adverse events following coronary stent placement identified using administrative claims data.
This study outlines the process used to identify adverse events following coronary stent placement identified with administrative claims data. Deterministic matching was used to link the National Cardiovascular Data Registry (NCDR) CathPCI Registry to Medicare fee-for-service claims for patients aged 65 and older who underwent percutaneous coronary interventions (PCIs) with drug-eluting stents (DESs) between July 2009 and December 2013. Out of 415,306 DES placements in 368,194 patients, 278 (1.1%) were attributed to the same coronary artery in which the DES was implanted during the index PCI. The authors concluded that more in-depth examination will be needed to accurately assess stent safety using claims data alone.
AHRQ-funded; HS022882.
Citation:
Dhruva, SS, Parzynski CS, Gamble GM .
Attribution of adverse events following coronary stent placement identified using administrative claims data.
J Am Heart Assoc 2020 Feb 18;9(4):e013606. doi: 10.1161/jaha.119.013606..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Surgery, Adverse Events, Registries
Lee BY, Bartsch SM, Hayden MK
How introducing a registry with automated alerts for carbapenem-resistant Enterobacteriaceae (CRE) may help control CRE spread in a region.
This study examined the effectiveness of implementing a registry which tracks patients that carry antibiotic-resistant bacteria, including carbapenem-resistant Enterobacteriaceae (CRE). The researchers developed an agent-based model of all inpatient healthcare facilities in the Chicago metropolitan area and surrounding areas. They used their Regional Healthcare Ecosystem Analyst software platform to study patient flow. They created scenarios where all, 75%, 50%, and 25% of Chicago-area facilities participated. Even at 25% participation there was a 9.1% relative reduction in incident carriers and 2.8% relative reduction of prevalence. At 100% there was an 11.6% relative reduction in new carrier and CRE prevalence by 7.6%.
AHRQ-funded; HS023317.
Citation:
Lee BY, Bartsch SM, Hayden MK .
How introducing a registry with automated alerts for carbapenem-resistant Enterobacteriaceae (CRE) may help control CRE spread in a region.
Clin Infect Dis 2020 Feb 14;70(5):843-49. doi: 10.1093/cid/ciz300..
Keywords:
Registries, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety
Amin AP, Spertus JA, Kulkarni H
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
This study examined ways to improve care pathways for acute coronary syndrome (ACS) patients who are low-risk with no complications. They looked at 434,172 low-risk uncomplicated ACS patients eligible for early discharge from the Premier database and identified ACS care pathways. They compared percutaneous coronary intervention (PCI) types (trans-radial intervention [TRI] vs. transfemoral intervention (TFI) and by length of stay (LOS). Associations with costs and outcomes were tested using hierarchical, mixed-effects regression and projections of cost savings were obtained using modeling. More cost-savings were associated with TRI versus TFI. There was not an increased risk of adverse outcomes with a shorter LOS.
AHRQ-funded; HS022481.
Citation:
Amin AP, Spertus JA, Kulkarni H .
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
Am J Cardiol 2020 Feb;125(3):354-61. doi: 10.1016/j.amjcard.2019.10.019..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Quality Improvement, Quality of Care, Healthcare Delivery, Registries, Healthcare Costs
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation:
Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
