National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (2)
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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 18 of 18 Research Studies DisplayedSchlick 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
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Yang AD, Hewitt DB, Blay E
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
The aims of this study were to: (1) measure the rate of failure to provide defect-free postoperative venous thromboembolism (VTE) chemoprophylaxis, (2) identify reasons for failure to provide defect-free VTE chemoprophylaxis, and (3) examine patient- and hospital-level factors associated with failure. The investigators concluded that in contrast to SCIP-VTE-2, their novel quality measure unmasked VTE chemoprophylaxis failures in 18% of colectomies. They found that most failures were due to patient refusals or ordering errors.
AHRQ-funded; HS024516.
Citation: Yang AD, Hewitt DB, Blay E .
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
Ann Surg 2020 Jun;271(6):1072-79. doi: 10.1097/sla.0000000000003124..
Keywords: Patient Adherence/Compliance, Guidelines, Blood Clots, Blood Thinners, Medication, Medication: Safety, Patient Safety, Adverse Events
Patel SA, Araujo T, Rodriguez LP
Long peripheral catheters: a retrospective review of major complications.
The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, the investigators did a retrospective review of major complications. Among other discoveries, they found LPCs were often placed for the indications of difficult access and long-term antibiotics.
AHRQ-funded; HS025891.
Citation: Patel SA, Araujo T, Rodriguez LP .
Long peripheral catheters: a retrospective review of major complications.
J Hosp Med 2019 Dec;14(12):758-60. doi: 10.12788/jhm.3313..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Blood Clots, Infectious Diseases, Risk
Kreutzer L, Yang AD, Sansone C
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
This study analyzed barriers for administration of VTE chemoprophylaxis to hospitalized patients from nurses. Researchers conducted 14 focus group interviews with nurses from five inpatient units to assess their perceptions of barriers to administration of VTE chemoprophylaxis. Barriers included nurses’ misconceptions that patients did not require chemoprophylaxis, their uncertainty when counseling patients on the importance of chemoprophylaxis, and a lack of comparative data regarding specific refusal rates.
AHRQ-funded; HS024516.
Citation: Kreutzer L, Yang AD, Sansone C .
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
J Hosp Med 2019 Nov 1;14(10):668-72. doi: 10.12788/jhm.3290..
Keywords: Blood Clots, Patient Safety, Prevention, Inpatient Care, Care Management, Nursing
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
Blay E, Huang R, Chung JW
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Patient Safety Indicator (PSI) 90 is a composite measure widely used in federal pay-for-performance and public reporting programs. A component metric of PSI 90, venous thromboembolism (VTE) rate, has been shown to be subject to surveillance bias and not a valid measure for hospital quality comparisons. A study was conducted to examine how hospital PSI 90 scores would change if the VTE measure were removed from calculation of this composite measure.
AHRQ-funded; HS021857.
Citation: Blay E, Huang R, Chung JW .
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Jt Comm J Qual Patient Saf 2019 Mar;45(3):148-55. doi: 10.1016/j.jcjq.2018.08.009..
Keywords: Blood Clots, Patient Safety, Quality Measures, Quality Indicators (QIs), Quality of Care
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
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Jindai K, Sterkel AK, Reed KD
Limb embolism in a 52-year-old woman.
In response to a photo quiz, the authors make the following diagnosis: arterial thrombus caused by Histoplasma capsulatum deriving from native valve endocarditis caused by the same organism. Various aspects of the case are discussed.
AHRQ-funded; HS022465; HS023779.
Citation: Jindai K, Sterkel AK, Reed KD .
Limb embolism in a 52-year-old woman.
Clin Infect Dis 2016 May 15;62(10):1320-1. doi: 10.1093/cid/ciw081.
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Keywords: Blood Clots, Care Management, Case Study, Diagnostic Safety and Quality, Patient Safety
Grant PJ, Greene MT, Chopra V
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
The authors examined how well the Caprini risk assessment model predicts venous thromboembolism in hospitalized medical patients. They concluded that the Caprini risk assessment model was unable to identify a subset of medical patients who benefit from pharmacologic prophylaxis.
AHRQ-funded; HS022835.
Citation: Grant PJ, Greene MT, Chopra V .
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
Am J Med 2016 May;129(5):528-35. doi: 10.1016/j.amjmed.2015.10.027.
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Keywords: Adverse Events, Blood Clots, Hospitalization, Risk, Patient Safety
Greene MT, Flanders SA, Woller SC
The association between PICC use and venous thromboembolism in upper and lower extremities.
The researchers examined the risk of venous thromboembolism in deep veins of the arm, leg, and chest after peripherally inserted central catheter placement (PICC). They found that PICC use is associated with upper- and lower-extremity deep vein thrombosis.
AHRQ-funded; HS022835.
Citation: Greene MT, Flanders SA, Woller SC .
The association between PICC use and venous thromboembolism in upper and lower extremities.
Am J Med 2015 Sep;128(9):986-93.e1. doi: 10.1016/j.amjmed.2015.03.028..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Fallouh N, McGuirk HM, Flanders SA
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
To better guide clinicians, the researchers performed a comprehensive literature review to summarize best practices for peripherally inserted central catheter-related deep vein thrombosis (PICC-DVT). They concluded that centrally positioned, otherwise functional and clinically necessary PICCs need not be removed despite concomitant DVT. Anticoagulation with low-molecular-weight heparin or warfarin for at least 3 months represents the mainstay of treatment.
AHRQ-funded; HS022835.
Citation: Fallouh N, McGuirk HM, Flanders SA .
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
Am J Med 2015 Jul;128(7):722-38. doi: 10.1016/j.amjmed.2015.01.027..
Keywords: Adverse Events, Blood Clots, Evidence-Based Practice, Patient Safety
Chopra V, Fallouh N, McGuirk H
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
The purpose of this study was to determine patterns, risk factors and treatment related to peripherally inserted central catheters-deep vein thrombosis (PICC-DVT) in hospitalized patients. It found that treatment for PICC-DVT varied and included heparin bridging, low molecular weight heparin only and device removal only; the average duration of treatment also varied across these groups.
AHRQ-funded; HS022835.
Citation: Chopra V, Fallouh N, McGuirk H .
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
Thromb Res 2015 May;135(5):829-34. doi: 10.1016/j.thromres.2015.02.012..
Keywords: Patient Safety, Blood Clots, Blood Thinners, Risk, Hospitalization
Michtalik HJ, Carolan HT, Haut ER
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
The researchers sequentially examined an individualized physician dashboard and pay-for-performance program to improve venous thromboembolism (VTE) prophylaxis rates among hospitalists. They found that direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program.
AHRQ-funded; HS017952; HS022331.
Citation: Michtalik HJ, Carolan HT, Haut ER .
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
J Hosp Med 2015 Mar;10(3):172-8. doi: 10.1002/jhm.2303..
Keywords: Provider Performance, Payment, Blood Clots, Prevention, Quality Improvement, Quality of Care, Hospitals, Patient Safety
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Radecki RP
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
In this letter commenting on an article on the treatment of stroke mimics, the author asserts that the difficult question of the acceptable rate of misdiagnosis remains. He suggests that patients undergoing thrombolytic therapy for acute ischemic stroke have confirmatory testing such as an MRI with diffusion-weighted sequences and that the incidence of neuroimaging negative events be reported.
AHRQ-funded; HS017586
Citation: Radecki RP .
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
Stroke. 2013 Sep;44(9):e105. doi: 10.1161/STROKEAHA.113.002040..
Keywords: Stroke, Decision Making, Patient Safety, Blood Clots