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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 15 of 15 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Mody P, Pandey A, Slutsky AS
AHRQ Author: Bierman AS
Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest.
In this study, the investigators examined gender based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest. Studies examining gender-based differences in outcomes of out-of-hospital cardiac arrest patients have demonstrated that despite a higher likelihood of return of spontaneous circulation, women do not have higher survival. The investigators concluded that among resuscitated out-of-hospital cardiac arrest patients, discharge to survival was significantly lower in women compared with men especially among patients considered to have a favorable prognosis.
AHRQ-authored.
Citation: Mody P, Pandey A, Slutsky AS .
Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest.
Circulation 2021 Feb 16;143(7):641-49. doi: 10.1161/circulationaha.120.050427..
Keywords: Sex Factors, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Hay CC, Graham JE, Pappadis MR
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
The goal of this retrospective observational study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. Subjects were Medicare fee-for-service beneficiaries discharged from inpatient rehabilitation facilities after a stroke. Results showed that when sociodemographic and clinical factors were controlled, females were more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who lived alone before their stroke had higher odds of discharging at a supervision level or better.
AHRQ-funded; HS022134.
Citation: Hay CC, Graham JE, Pappadis MR .
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
Am J Phys Med Rehabil 2020 Jan;99(1):48-55. doi: 10.1097/phm.0000000000001276..
Keywords: Stroke, Rehabilitation, Elderly, Patient-Centered Outcomes Research, Sex Factors, Cardiovascular Conditions, Outcomes
Purnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
AHRQ-funded; HS024600.
Citation: Purnell TS, Luo X, Crews DC .
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
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Keywords: Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Elderly, Sex Factors, Surgery, Kidney Disease and Health, Disparities, Outcomes, Patient-Centered Outcomes Research
Sutherland S, Brunwasser SM
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
This review evaluates the degree to which recent studies provide evidence that prenatal maternal stress (PNMS) has a varying effect on child health outcomes depending on the child's biological sex. “Stress” includes negative life events, psychological stress, and established stress biomarkers. A review of 50 peer-reviewed articles revealed that most found evidence of either sex-specific associations or significant PNMS (x) stress interactions for at least one outcome. Sex-dependent effects were strongest in the group of studies that evaluated child neural/nervous system development and temperament.
AHRQ-funded; HS022990.
Citation: Sutherland S, Brunwasser SM .
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
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Keywords: Children/Adolescents, Newborns/Infants, Outcomes, Pregnancy, Sex Factors, Stress
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Lau KSL, Rosenman MB, Wiehe SE
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
The objective of this study was to assess the simultaneous effects of gender, race/ethnicity, and pre-arrest behavioral health (BH) service-use on age at first arrest, and first arrest outcomes. It found that black youth were arrested at younger ages than white or Hispanic youth. Youth with psychiatric problems were arrested at younger ages than youth with substance-use, dual-diagnoses, or no BH problems.
AHRQ-funded; HS024296; HS023318.
Citation: Lau KSL, Rosenman MB, Wiehe SE .
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
J Behav Health Serv Res 2018 Apr;45(2):237-51. doi: 10.1007/s11414-017-9578-3.
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Keywords: Behavioral Health, Outcomes, Racial and Ethnic Minorities, Sex Factors
Kochkodan J, Telem DA, Ghaferi AA
Physiologic and psychological gender differences in bariatric surgery.
This paper aims to describe differences in bariatric surgery outcomes by gender and to understand the physiologic and psychological differences that may explain this gender gap. It concludes that, despite significantly lower weight loss and increased complication rates, males tend to have markedly higher satisfaction and psychological well-being scores than females.
AHRQ-funded; HS023621; HS024403.
Citation: Kochkodan J, Telem DA, Ghaferi AA .
Physiologic and psychological gender differences in bariatric surgery.
Surg Endosc 2018 Mar;32(3):1382-88. doi: 10.1007/s00464-017-5819-z.
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Keywords: Obesity, Outcomes, Sex Factors, Surgery, Obesity: Weight Management
Lipman GS, Krabak BJ, Rundell SD
Incidence and prevalence of acute kidney injury during multistage ultramarathons.
The objective of this study was to determine the prevalence, incidence, and risk factors of acute kidney injury (AKI) during multistage ultramarathons. The authors found that prevalence of AKI was 63%-78% during multistage ultramarathons, and that female sex, lower pack weight, and greater weight loss were associated with renal impairment.
AHRQ-funded; HS022982.
Citation: Lipman GS, Krabak BJ, Rundell SD .
Incidence and prevalence of acute kidney injury during multistage ultramarathons.
Clin J Sport Med 2016 Jul;26(4):314-9. doi: 10.1097/jsm.0000000000000253.
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Keywords: Injuries and Wounds, Risk, Sex Factors, Outcomes
Piccini JP, Simon DN, Steinberg BA
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
The purpose of this paper was to determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with atrial fibrillation (AF). The authors found that women with AF have more symptoms and worse quality of life, lower risk-adjusted all-cause and cardiovascular death compared with men, but higher stroke rates.
AHRQ-funded; HS021092.
Citation: Piccini JP, Simon DN, Steinberg BA .
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
JAMA Cardiol 2016 Jun 1;1(3):282-91. doi: 10.1001/jamacardio.2016.0529.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Registries, Evidence-Based Practice
Duffy RP, Adams JE, Callas PW
The influence of gender on functional outcomes of lower extremity bypass.
The researchers aimed to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). They found that women have complication rates similar to men with inferior early and late functional outcomes after LEB. The reduced patency rates in women with critical limb ischemia did not translate into differences in limb salvage.
AHRQ-funded; HS021581.
Citation: Duffy RP, Adams JE, Callas PW .
The influence of gender on functional outcomes of lower extremity bypass.
J Vasc Surg 2014 Nov;60(5):1282-90, 90.e1. doi: 10.1016/j.jvs.2014.05.008.
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Keywords: Cardiovascular Conditions, Outcomes, Sex Factors, Surgery
Strom Williams JL, Lynch CP, Winchester R
Gender differences in composite control of cardiovascular risk factors among patients with type 2 diabetes.
This study examined the gender differences in multiple cardiovascular disease (CVD) risk factor control in adults with type 2 diabetes seen in diverse clinical settings. It found that women had significantly poorer composite control of CVD risk outcomes compared with men, adjusting for relevant confounding factors. In unadjusted analyses, women had higher mean systolic blood pressure and LDL cholesterol levels compared with men.
AHRQ-funded; HS011418.
Citation: Strom Williams JL, Lynch CP, Winchester R .
Gender differences in composite control of cardiovascular risk factors among patients with type 2 diabetes.
Diabetes Technol Ther 2014 Jul;16(7):421-7. doi: 10.1089/dia.2013.0329..
Keywords: Cardiovascular Conditions, Risk, Diabetes, Outcomes, Sex Factors
Boehme AK, Siegler JE, Mullen MT
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
This study sought to determine the association of race and gender on initial stroke severity, thrombolysis, and functional outcome after acute ischemic stroke (AIS). The investigators concluded that race and gender were not significantly associated with short-term outcome, although black women were significantly less likely to be treated with tissue plasminogen activator (tPA). Black women had more tPA exclusions than any other group. The primary reason for tPA exclusion in this study was not arriving within 3 hours of stroke symptom onset.
AHRQ-funded; HS013852.
Citation: Boehme AK, Siegler JE, Mullen MT .
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
J Stroke Cerebrovasc Dis 2014 Apr;23(4):e255-61. doi: 10.1016/j.jstrokecerebrovasdis.2013.11.003..
Keywords: Racial and Ethnic Minorities, Outcomes, Sex Factors, Stroke