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- Adverse Events (5)
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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 25 of 28 Research Studies DisplayedOfoma UR, Drewry AM, Maddox TM
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
This study compared survival rates for inpatients who suffered in-hospital cardiac arrest (IHCA) who had access to Telemedicine Critical Care (TCC) during nights and weekends (off-hours) compared to those who did not. The authors identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. The majority (60.6%) of IHCAs occurred in an ICU, and 32.2% participants suffered IHCA at hospitals with TCC. No difference was found in acute resuscitation survival rates or survival to discharge rates for either IHCA between TCC and non-TCC hospitals. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival or survival to discharge.
AHRQ-funded; HS019455.
Citation: Ofoma UR, Drewry AM, Maddox TM .
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
Resuscitation 2022 Aug;177:7-15. doi: 10.1016/j.resuscitation.2022.06.008..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Outcomes, Critical Care, Intensive Care Unit (ICU)
Capone CA, Emerson B, Sweberg T
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
The purpose of this study was to describe Tracheal Intubation (TI) practice and outcomes in pediatric Emergency Departments as compared to those in intensive care units (ICUs) and use the resulting data to identify targets for quality improvement. The researchers analyzed consecutive TI encounters from pediatric EDs and ICUs in the National Emergency Airway Registry for Children (NEAR4KIDS) database from 2015 to 2018. The study found a total of 12,512 TIs in 51 pediatric/cardiac ICUs, and 756 TIs in 13 pediatric EDs and were reported. Proportion of TIs for shock (26% ED vs. 14% ICU), respiratory decompensation (52% vs. 64%), and neurologic deterioration (30% vs. 11%) also differed by location. Limited neck mobility was reported more often in the ED (16% vs. 6%). TIs in the ED were performed more often via video laryngoscopy (64% vs. 29%). Oxygen desaturation was less commonly reported in ED TIs (13.6%) than ICU TIs (17%). Among ED TIs, shock as an indication and limited mouth opening were independently associated with adverse TI-associated events (TIAEs). The study concluded that TI characteristics vary between pediatric EDs and ICUs, yet outcomes are similar.
AHRQ-funded; HS022464.
Citation: Capone CA, Emerson B, Sweberg T .
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
Acad Emerg Med 2022 Apr;29(4):406-14. doi: 10.1111/acem.14431..
Keywords: Children/Adolescents, Emergency Department, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Critical Care, Intensive Care Unit (ICU)
Anesi GL, Liu VX, Chowdhury M
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
ICU capacity is strained and its capacity and effectiveness are limited because many patient admission decisions are not evidence-based regarding who benefits from admission triage. The purpose of the study was to measure the benefits of admission to the ICU in patients who were experiencing sepsis or acute respiratory failure. Researchers looked retrospectively from 2013 to 2018 at cohorts within 27 U.S. hospitals across two health systems. They compared ICU admission vs ward admission among patients with sepsis and/ or acute respiratory failure who did not require vasopressors or mechanical ventilation in the emergency department. Study results revealed in patients with sepsis that ICU admission was associated with a hospital stay of 1.32 days longer than ward admissions, with a higher in-hospital mortality ratio. In patients with respiratory failure, ICU admission was associated with a .82-day shorter length of stay and reduced in-patient mortality. Within the two groups, subgroup analysis was conducted, and results revealed that for patients with sepsis, harms were concentrated among older patients and patients with fewer comorbidities. In addition, for patients with respiratory failure, the benefits were concentrated among older patients, patients with higher lab-based acute physiology scores (“high acuity” patients), and patients with comorbidities. The study concluded that among sepsis patients with high acuity scores and not requiring life support in the emergency department, initial admission to the ward was associated with shorter length of stay and improved survival, compared to the same category of patients admitted to the ICU. This result differed from patients with acute respiratory failure, for whom triage to the ICU was associated with improved survival when compared to admission to the ward.
AHRQ-funded; HS026372.
Citation: Anesi GL, Liu VX, Chowdhury M .
Association of ICU admission and outcomes in sepsis and acute respiratory failure.
Am J Respir Crit Care Med 2022 Mar 1;205(5):520-28. doi: 10.1164/rccm.202106-1350OC..
Keywords: Intensive Care Unit (ICU), Sepsis, Respiratory Conditions, Outcomes
Savarimuthu SM, Cairns C, Allorto NL SM, Cairns C, Allorto NL
qSOFA as a predictor of ICU outcomes in a resource-limited setting in KwaZulu-Natal Province, South Africa.
This study’s goal was to determine whether the quick sequential organ failure assessment (qSOFA) score based on bedside assessment alone was a promising tool for risk prediction in low-resource settings. This retrospective cohort study included adult patients admitted to the intensive care unit (ICU) at Edendale Hospital in Pietermaritzburg, South Africa (SA), recruited into the study between 2014 and 2018. Using multivariable logistic regression, the association of qSOFA with in-ICU mortality was measured, and discrimination was assessed using the area under the receiver operating characteristic curve and the additive contribution to a baseline model using likelihood ratio testing. The qSOFA scores of 0, 1 and 2 were not associated with increased odds of in-ICU mortality in patients with infection, while the qSOFA of 3 was associated with in-ICU mortality in infected patients. Discrimination for mortality was fair to poor and adding qSOFA to a baseline model yielded a statistical improvement in both cases.
AHRQ-funded; HS026372.
Citation: Savarimuthu SM, Cairns C, Allorto NL SM, Cairns C, Allorto NL .
qSOFA as a predictor of ICU outcomes in a resource-limited setting in KwaZulu-Natal Province, South Africa.
South Afr J Crit Care 2020; 36(2). doi: 10.7196/SAJCC.2020.v36i2.433..
Keywords: Intensive Care Unit (ICU), Sepsis, Critical Care, Outcomes
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation: Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords: COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Anesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
Bowman JA, Nuño M, Jurkovich GJ
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
Researchers characterized interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and evaluated whether greater hospital-level use of ICU admission is associated with improved outcomes. This study included trauma patients who were admitted to trauma centers participating in the National Trauma Data Bank. The researchers found that admission location of older patients with isolated rib fractures was variable across hospitals, but hospitalization at a center with greater ICU use was associated with improved outcomes. They recommended that hospitals with low ICU use admit more such patients to an ICU.
AHRQ-funded; HS022236.
Citation: Bowman JA, Nuño M, Jurkovich GJ .
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
JAMA Netw Open 2020 Nov 2;3(11):e2026500. doi: 10.1001/jamanetworkopen.2020.26500..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Hospitals, Patient-Centered Outcomes Research, Outcomes, Mortality
Balmaks R, Whitfill TM, Ziemele B
Pediatric readiness in the emergency department and its association with patient outcomes in critical care: a prospective cohort study.
The purpose of this study was to assess the quality of pediatric acute care and pediatric readiness and to determine their association with patient outcomes using a patient registry. Studying all Latvian Emergency Departments and the national PICU, researchers’ findings showed that a higher weighted pediatric readiness score was associated significantly with lower length of stay in both the PICU and hospital and lower 6-month mortality. Pediatric readiness in the emergency department was associated with patient outcomes in this population of pediatric patients transferred to the national PICU.
AHRQ-funded; HS020286.
Citation: Balmaks R, Whitfill TM, Ziemele B .
Pediatric readiness in the emergency department and its association with patient outcomes in critical care: a prospective cohort study.
Pediatr Crit Care Med 2020 May;21(5):e213-e20. doi: 10.1097/pcc.0000000000002255..
Keywords: Children/Adolescents, Emergency Department, Critical Care, Intensive Care Unit (ICU), Outcomes
Kelly Costa D, Liu H, Boltey EM
The structure of critical care nursing teams and patient outcomes: a network analysis.
This examined the connectiveness of critical nursing teams and patient outcomes. The study measured “coreness” (the degree to which a network is represented by a densely integrated core) and “betweenness” (whether a nurse lies on the path of others not directly connected). The researchers used ICU data from a medical center during 2011 and looked at nurses who worked in surgical ICU (SICU) or neurosurgical ICU (NICU) during that same time period. The sample included 598 adult patients and 281 nurses. The researchers found that the greater the coreness of the team, and the more betweenness there was with ICU nurses the less likely patients were to die.
AHRQ-funded; HS024552.
Citation: Kelly Costa D, Liu H, Boltey EM .
The structure of critical care nursing teams and patient outcomes: a network analysis.
Am J Respir Crit Care Med 2020 Feb 15;201(4):483-85. doi: 10.1164/rccm.201903-0543LE..
Keywords: Intensive Care Unit (ICU), Critical Care, Nursing, Teams, Outcomes, Healthcare Delivery, Patient-Centered Outcomes Research, Patient-Centered Healthcare
Tignanelli CJ, Sheetz KH, Petersen A
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes. Data from the Healthcare Cost and Utilization Project's state inpatient databases was utilized from 2010 - 2014. A multilevel logistic regression model was used to evaluate the relationship between NC and clinical outcomes. The investigators concluded that rates of NC were low in critically ill patients.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Sheetz KH, Petersen A .
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
JPEN J Parenter Enteral Nutr 2020 Feb;44(2):213-19. doi: 10.1002/jpen.1534..
Keywords: Healthcare Cost and Utilization Project (HCUP), Intensive Care Unit (ICU), Nutrition, Patient-Centered Outcomes Research, Outcomes, Critical Care, Mortality
Bowman JA, Jurkovich GJ, Nishijima DK
Older adults with isolated rib fractures do not require routine intensive care unit admission.
This study examined whether older adults with isolated rib fractures should be admitted to an intensive care unit (ICU) due to higher presumed morbidity and mortality. Patients 50 years and older who were admitted between 2013 and 2017 were analyzed. The outcomes being looked at were any critical care intervention or adverse event based on accepted critical care guidelines. Out of 401 patients, 251 (63%) were admitted to the ICU. In the ICU, 33% experienced an adverse event while only 7% admitted to the ward experienced an adverse event. The most common events were hypotension, frequent respiratory therapy and oxygen desaturation. Predictors of these events included incentive spirometry, use of a walker, increased chest Abbreviated Injury Scale score, age 72 or greater, and active smoking. The investigators concluded routine ICU admission is not necessary for most older adults with isolated rib fractures.
AHRQ-funded; HS022236.
Citation: Bowman JA, Jurkovich GJ, Nishijima DK .
Older adults with isolated rib fractures do not require routine intensive care unit admission.
J Surg Res 2020 Jan;245:492-99. doi: 10.1016/j.jss.2019.07.098..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Outcomes
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Hussain FS, Sosa T, Ambroggio L
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
This case-control study aimed to determine the predictive validity of an emergency transfer (ET) for outcomes in a free-standing children's hospital. Controls were matched in terms of age, hospital unit, and time of year. Patients who experienced an ET had a significantly higher likelihood of in-hospital mortality (22% vs 9%), longer ICU length of stay (4.9 vs 2.2 days), and longer posttransfer length of stay (26.4 vs 14.7 days) compared with controls (P < .03 for each).
AHRQ-funded; HS023827.
Citation: Hussain FS, Sosa T, Ambroggio L .
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
J Hosp Med 2019 Aug;14(8):482-85. doi: 10.12788/jhm.3219..
Keywords: Transitions of Care, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Outcomes, Patient-Centered Outcomes Research, Inpatient Care, Hospitalization, Hospitals, Healthcare Delivery
Sanders R, Edwards L, Nishisaki A
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
This editorial discusses a research study on outcomes of performing pediatric trachael intubations (TIs) and how the results can be applied to performing intubations on critically ill children in the United Kingdom outside of specialized centers. One of the authors is from a U.S. site that submits its airway management data to the National Emergency Airway Registry for Children (NEAR4KIDS). The results from the registry were compared to the results from the study. A total of 1,051 patients out of 1,237 eligible patients were analyzed. The results came from 47 nonspecialized local hospitals in the North Thames and East Anglia region of the UK. Adverse TI-associated events (TIAEs) occurred in 22.7% of the patients, which is higher than those in PICUs and cardiac ICUs. The majority of intubations were performed by the anesthesiologist in the team. The results were similar to those in the NEAR4KIDS registry. There were more complications with children with a higher grade of airway difficulties and comorbidities. The authors believe that pediatric airway management for acutely ill children would benefit from new strategies. They recommend a system change using Plan, Do, Study, Act (PDSA) cycles.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Sanders R, Edwards L, Nishisaki A .
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
Pediatr Crit Care Med 2019 Jun;20(6):572-73. doi: 10.1097/pcc.0000000000001946..
Keywords: Adverse Events, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Outcomes, Patient Safety, Registries, Respiratory Conditions
Foglia EE, Ades A, Sawyer T
Neonatal intubation practice and outcomes: an international registry study.
Neonatal tracheal intubation is a critical but potentially dangerous procedure. In this study, the investigators sought to characterize intubation practice and outcomes in the NICU and delivery room (DR) settings and to identify potentially modifiable factors to improve neonatal intubation safety. They developed the National Emergency Airway Registry for Neonates and collected standardized data for patients, providers, practices, and outcomes of neonatal intubation. They suggest that their results will inform future interventional studies to improve neonatal intubation safety.
AHRQ-funded; HS024511.
Citation: Foglia EE, Ades A, Sawyer T .
Neonatal intubation practice and outcomes: an international registry study.
Pediatrics 2019 Jan;143(1). doi: 10.1542/peds.2018-0902..
Keywords: Emergency Department, Health Services Research (HSR), Intensive Care Unit (ICU), Newborns/Infants, Outcomes, Patient Safety, Registries
Lee JH, Nuthall G, Ikeyama T
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Researchers hypothesized that there would be differences in the process of care and adverse outcomes for tracheal intubation across pediatric ICUs (PICUs) in six different geographical regions: Germany, Japan, Singapore, India, New Zealand, and North America. Adverse tracheal intubation-associated events and desaturation occurrences in PICUS in these regions were evaluated, and the international PICUs compared with those in North America. The proportion of tracheal intubations for endotracheal tube change was greater in international PICUs, and the median age for international tracheal intubations was younger when compared with North America PICUs. Occurrences of adverse tracheal intubation-associated events were slightly lower for international than for North American PICUs, except for Germany and Japan, which were slightly higher.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Lee JH, Nuthall G, Ikeyama T .
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Pediatr Crit Care Med 2019 Jan;20(1):1-8. doi: 10.1097/pcc.0000000000001782..
Keywords: Adverse Events, Care Management, Children/Adolescents, Intensive Care Unit (ICU), Respiratory Conditions, Outcomes, Patient Safety
Law AC, Stevens JP, Hohmann S
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
The objective of this study was to assess whether Massachusetts legislation directed at ICU nurse staffing was associated with improvements in patient outcomes. The investigators found that state regulation of patient-to-nurse staffing with the aid of patient complexity scores in intensive care was not associated with either increased nurse staffing or changes in patient outcomes.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Hohmann S .
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
Crit Care Med 2018 Sep 4;46(10):1563-69. doi: 10.1097/ccm.0000000000003286..
Keywords: Intensive Care Unit (ICU), Policy, Nursing, Outcomes, Patient Safety
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Sinha SS, Sjoding MW, Sukul D
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
This study examined changes in primary noncardiac diagnoses among elderly patients admitted to a cardiac intensive care unit (CICU) during the past decade. More than half of all elderly patients with a CICU stay across the United States now have primary noncardiac diagnoses at discharge. These patients receive different types of care and have worse outcomes than patients with primary cardiac diagnoses.
AHRQ-funded; HS020672.
Citation: Sinha SS, Sjoding MW, Sukul D .
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
Circ Cardiovasc Qual Outcomes 2017 Aug;10(8):e003616. doi: 10.1161/circoutcomes.117.003616.
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Keywords: Elderly, Heart Disease and Health, Intensive Care Unit (ICU), Outcomes, Respiratory Conditions
Valley TS, Sjoding MW, Ryan AM
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
The researchers estimated the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI). They found that ICU admission did not confer a survival benefit for patients with uncertain ICU needs hospitalized with COPD exacerbation, HF exacerbation, or AMI.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction.
Ann Am Thorac Soc 2017 Jun;14(6):943-51. doi: 10.1513/AnnalsATS.201611-847OC.
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Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Heart Disease and Health, Outcomes
Harrison AM, Gajic O, Pickering BW
Development and implementation of sepsis alert systems.
Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Current evidence does not support routine use of sepsis alert systems in clinical practice. Continuous improvement in the afferent and efferent aspects will help translate theoretic advantages into measurable patient benefit.
AHRQ-funded; HS022799.
Citation: Harrison AM, Gajic O, Pickering BW .
Development and implementation of sepsis alert systems.
Clin Chest Med 2016 Jun;37(2):219-29. doi: 10.1016/j.ccm.2016.01.004..
Keywords: Intensive Care Unit (ICU), Sepsis, Outcomes, Adverse Events
McElroy LM, Khorzad R, Nannicelli AP
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
The investigators compared a simplified scoring method with the traditional scoring method to determine the degree of congruence in identifying high-risk failures. They found that the simplified method did not result in the same degree of discrimination in the ranking of failures offered by the traditional method.
AHRQ-funded; HS000078.
Citation: McElroy LM, Khorzad R, Nannicelli AP .
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
BMJ Qual Saf 2016 May;25(5):329-36. doi: 10.1136/bmjqs-2015-004130.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Outcomes, Patient Safety, Risk
Wong EG, Parker AM, Leung DG
Association of severity of illness and intensive care unit readmission: a systematic review.
This study sought to determine whether ICU readmission is associated with higher severity of illness scores in adult patients. In most of the 31 studies included in the analysis, severity of illness scores were higher in patients readmitted to the ICU. Readmission was also associated with higher mortality and longer ICU and hospital stays.
AHRQ-funded; HS022916.
Citation: Wong EG, Parker AM, Leung DG .
Association of severity of illness and intensive care unit readmission: a systematic review.
Heart Lung 2016 Jan-Feb;45(1):3-9.e2. doi: 10.1016/j.hrtlng.2015.10.040.
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Keywords: Intensive Care Unit (ICU), Hospital Readmissions, Hospital Discharge, Outcomes
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes