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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 17 of 17 Research Studies DisplayedScaife JH, Bryce JR, Iantorno SE
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
The term “Undertriage” refers to the treatment of patients at facilities lacking in the equipment needed to treat the patient's injuries appropriately. The purpose of this retrospective cohort study was to assess the relationship between patient and hospital characteristics and secondary undertriage in children after major trauma. The researchers utilized the 2019 Nationwide Emergency Department Sample and included patients aged less than 18 years of age if they presented to a Level 3 or non-trauma center (NTC) and were diagnosed with a traumatic injury with an injury severity score of greater than 15 based on International Classification of Diseases 10 codes. The study found that of 6,572 weighted patients, 15% were undertriaged. Undertriage was significantly associated with older age, metropolitan location, and major abdominal injuries. After multivariable adjustment, secondary undertriage was significantly associated with patients aged 6-10 years of age compared to patients aged 15-17 years, penetrating injury, major chest injury, and presentation at a teaching hospital.
AHRQ-funded; HS025776.
Citation: Scaife JH, Bryce JR, Iantorno SE .
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
J Surg Res 2024 Jan; 293:37-45. doi: 10.1016/j.jss.2023.07.054..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Injuries and Wounds
Hoffmann JA, Carter CP, Olsen CS
Pediatric firearm injury emergency department visits from 2017 to 2022: a multicenter study.
This retrospective study aimed to assess how pediatric firearm injury emergency department (ED) visits during the pandemic differed from expected prepandemic trends. The authors looked at firearm injury ED visits by children <18 years old at 9 US hospitals participating in the Pediatric Emergency Care Applied Research Network Registry before (January 2017 to February 2020) and during (March 2020 to November 2022) the pandemic. They calculated rate ratios (RRs) of observed to expected visits per 30 days, overall, and by sociodemographic characteristics. They identified 1904 firearm injury ED visits (52.3% 15-17 years old, 80.0% male, 63.5% non-Hispanic Black), with 694 prepandemic visits and 1210 visits during the pandemic. Death in the ED/hospital increased from 3.1% prepandemic to 6.1% during the pandemic. Firearm injury visits per 30 days increased from 18.0 prepandemic to 36.1 during the pandemic (RR 2.09). Increases beyond expected rates were seen for 10- to 14-year-olds (RR 2.61), females (RR 2.46), males (RR 2.00), Hispanic children (RR 2.30), and Black non-Hispanic children (RR 1.88).
AHRQ-funded; R01HS020270.
Citation: Hoffmann JA, Carter CP, Olsen CS .
Pediatric firearm injury emergency department visits from 2017 to 2022: a multicenter study.
Pediatrics 2023 Dec; 152(6). doi: 10.1542/peds.2023-063129..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Injuries and Wounds
Nguyen JK, P P
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
This study’s objective was to compare level 1 and 2 trauma centers with similarly sized non-trauma centers on survival after major trauma among older adults. The authors used claims of 100% of 2012-2017 Medicare fee-for-service beneficiaries who received hospital care after major trauma. They assessed the roles of prehospital care, hospital quality, and volume. Thirty-day mortality was higher overall at level 1 versus non-trauma centers by 2.2 percentage points (pp). Thirty-day mortality was higher at level 1 versus non-trauma centers by 2.3 pp for falls and 2.3 pp for motor vehicle crashes. Outcomes were similar at level 1 and 2 trauma centers. The difference was not explained by hospital quality and volume. There were also no statistical differences in the ambulance-transported group, after adjusting for prehospital variables.
AHRQ-funded; HS025720.
Citation: Nguyen JK, P P .
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
Health Serv Res 2023 Aug; 58(4):817-27. doi: 10.1111/1475-6773.14148..
Keywords: Elderly, Trauma, Outcomes, Injuries and Wounds, Emergency Department, Hospitals
Goyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation: Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords: Children/Adolescents, Opioids, Emergency Department, Racial and Ethnic Minorities, Injuries and Wounds, Pain, Medication
Henry MK, French B, Feudtner C
Cervical spine imaging and injuries in young children with non-motor vehicle crash-associated traumatic brain injury.
Researchers evaluated cervical magnetic resonance imaging and computed tomography practices and cervical spine injuries among a stratified random sample of young children with non-motor vehicle crash-associated traumatic brain injury (TBI). They found that abusive head trauma victims appeared to be at increased risk of cervical injuries. They recommended prospective studies to define the risk of cervical injury in children with TBI concerning for abusive head trauma and to inform development of imaging guidelines.
AHRQ-funded; HS024194.
Citation: Henry MK, French B, Feudtner C .
Cervical spine imaging and injuries in young children with non-motor vehicle crash-associated traumatic brain injury.
Pediatr Emerg Care 2021 Jan;37(1):e1-e6. doi: 10.1097/pec.0000000000001455..
Keywords: Children/Adolescents, Imaging, Injuries and Wounds, Injuries and Wounds, Emergency Department
Drendel AL, Brousseau DC, Casper TC
Opioid prescription patterns at emergency department discharge for children with fractures.
The authors sought to measure the variability in discharge opioid prescription practices for children discharged from the emergency department (ED) with a long-bone fracture. They found that, for children with a long-bone fracture, discharge opioid prescription varied widely by ED site of care. In addition, black patients, Hispanic patients, and patients with government insurance were less likely to be prescribed opioids. This variability in opioid prescribing was not accounted for by patient- or injury-related factors that are associated with increased pain.
AHRQ-funded; HS020270.
Citation: Drendel AL, Brousseau DC, Casper TC .
Opioid prescription patterns at emergency department discharge for children with fractures.
Pain Med 2020 Sep;21(9):1947-54. doi: 10.1093/pm/pnz348..
Keywords: Children/Adolescents, Opioids, Medication, Emergency Department, Injuries and Wounds, Practice Patterns
Mueller KL, Naganathan S, Griffey RT
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
The authors evaluated the feasibility of the Counseling on Access to Lethal Means intervention in the Emergency Department (CALM-ED) by non-physician personnel. Their quality improvement study was conducted in an urban, academic ED with over 90,000 annual patient visits, and considered adult patients who were discharged after presenting to the ED with a suicidal crisis. They found that an ED-based CALM quality-improvement intervention was feasible for implementation by non-physician personnel and was well received by patients and families. They concluded that the intervention has the potential to help saves lives at times of suicide crisis.
AHRQ-funded; HS025052.
Citation: Mueller KL, Naganathan S, Griffey RT .
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
West J Emerg Med 2020 Aug 20;21(5):1123-30. doi: 10.5811/westjem.2020.5.46952.
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Keywords: Emergency Department, Injuries and Wounds, Prevention, Quality Improvement, Quality of Care, Domestic Violence, Behavioral Health
Chovatiya R, Silverberg JI
Association of pemphigus and pemphigoid with osteoporosis and pathological fractures.
Researchers sought to determine whether pemphigus and bullous pemphigoid (BP) are associated with osteoporosis and fractures in the US. Subjects for this cross-sectional study included adults with pemphigus or with BP from the 2006-2012 National Emergency Department Sample. The researchers found that, when compared to BP, pemphigus was associated with higher odds of osteopenia, osteoporosis, and fractures, particularly of the ulna and radius. Patients with pemphigus or BP as well as long-term systemic corticosteroid use had the highest odds of osteoporosis and fractures. The researchers suggested that patients with these conditions may benefit from increased screening for osteoporosis and interventions to prevent fractures.
AHRQ-funded; HS023011.
Citation: Chovatiya R, Silverberg JI .
Association of pemphigus and pemphigoid with osteoporosis and pathological fractures.
Arch Dermatol Res 2020 May;312(4):263-71. doi: 10.1007/s00403-019-02010-y..
Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Emergency Department
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in emergency department pain management of children with fractures.
Researchers tested the hypotheses that minority children with long-bone fractures are less likely to receive analgesics, to receive opioid analgesics, and to achieve pain reduction. Using data from the Pediatric Emergency Care Applied Research Network Registry, they found that there are differences in process and outcome measures by race and ethnicity in the emergency department management of pain among children with long-bone fractures. Although minority children are more likely to receive analgesics and achieve reduction in pain, they are less likely to receive opioids and achieve optimal pain reduction.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in emergency department pain management of children with fractures.
Pediatrics 2020 May;145(5):e20193370. doi: 10.1542/peds.2019-3370..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Emergency Department, Pain, Injuries and Wounds, Medication, Opioids, Disparities
Shaheen MS, Silverberg JI
Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures.
Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. The objective of this study was to determine whether asthma was associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. The investigators concluded that ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.
Citation: Shaheen MS, Silverberg JI .
Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures.
Allergy Asthma Proc 2020 Mar 1;41(2):112-19. doi: 10.2500/aap.2020.41.190035.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Emergency Department
Zive D, Newgard CD, Lin A
Injured older adults transported by emergency medical services: one year outcomes by POLST status.
Advance care planning documents, including Physician Orders for Life-Sustaining Treatment (POLST), are intended to guide care near end of life, particularly in emergency situations. Yet, research on POLST during emergency care is sparse. This study examined one year outcomes, by Physician Orders for Life-Sustaining Treatment status, of injured adults transported by EMS. The investigators concluded that among injured older adults transported by ambulance in Oregon, one in 5 had an active POLST form at the time of 9-1-1 contact, the prevalence of which increased over the following year.
AHRQ-funded; HS023796.
Citation: Zive D, Newgard CD, Lin A .
Injured older adults transported by emergency medical services: one year outcomes by POLST status.
Prehosp Emerg Care 2020 Mar-Apr;24(2):257-64. doi: 10.1080/10903127.2019.1615154..
Keywords: Elderly, Injuries and Wounds, Emergency Medical Services (EMS), Emergency Department
Zins ZP, Wheeler KK, Brink F
Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006-2014.
The purpose of this study was to determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses. The investigators found that definitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias.
AHRQ-funded; HS024263.
Citation: Zins ZP, Wheeler KK, Brink F .
Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006-2014.
Child Abuse Negl 2019 Dec;98:104179. doi: 10.1016/j.chiabu.2019.104179..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Diagnostic Safety and Quality, Domestic Violence, Injuries and Wounds, Emergency Department, Hospitalization
Meagher AD, Lin A, Mandell SP
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Researchers conducted a retrospective cohort study to identify injured older adults at highest risk for 30-day mortality. They found that older, injured adults transported by EMS to a large variety of trauma and non-trauma hospitals were more likely to die within 30 days if they required emergent airway management or had a higher comorbidity burden. They concluded that identification of an ideal prognostic tool remains elusive.
AHRQ-funded; HS023796.
Citation: Meagher AD, Lin A, Mandell SP .
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Acad Emerg Med 2019 Jun;26(6):621-30. doi: 10.1111/acem.13727..
Keywords: Elderly, Trauma, Mortality, Injuries and Wounds, Emergency Department
Newgard CD, Malveau S, Zive D
Building a longitudinal cohort from 9-1-1 to 1-year using existing data sources, probabilistic linkage, and multiple imputation: a validation study.
The objective of this seven-county study was to describe and validate construction of a population-based, longitudinal cohort of injured older adults from 9-1-1 call to 1-year follow-up. Results showed that a population-based emergency care cohort with long-term outcomes can be constructed from existing data sources with high accuracy and reasonable validity of resulting variables.
AHRQ-funded; HS023796.
Citation: Newgard CD, Malveau S, Zive D .
Building a longitudinal cohort from 9-1-1 to 1-year using existing data sources, probabilistic linkage, and multiple imputation: a validation study.
Acad Emerg Med 2018 Nov;25(11):1268-83. doi: 10.1111/acem.13512..
Keywords: Data, Research Methodologies, Elderly, Emergency Department, Injuries and Wounds
Yun BJ, Borczuk P, Zachrison KS
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
This study examined national trends in utilization of head computed tomography (CT) imaging in emergency department (ED) patients presenting with an injury-related visit. Data from the US National Hospital Ambulatory Medical Care Survey from 2012 to 2015 was used to find ED patients who had at least one head CT. Overall there was an increase (11.7-13.23%) but it was not statistically significant.
AHRQ-funded; HS024561.
Citation: Yun BJ, Borczuk P, Zachrison KS .
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
Am J Emerg Med 2018 Aug;36(8):1463-66. doi: 10.1016/j.ajem.2018.05.018..
Keywords: Healthcare Utilization, Emergency Department, Imaging, Injuries and Wounds, Practice Patterns
Vogel JA, Newgard CD, Holmes JF
Validation of the Denver emergency department trauma organ failure score to predict post-injury multiple organ failure.
The objective of the study was to externally validate the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, a 6-item instrument that includes age, intubation, hematocrit, systolic blood pressure, blood urea nitrogen, and white blood cell count, which was designed to predict the development of multiple organ failure (MOF) within 7 days of hospitalization. It was determined that the Denver ED TOF Score predicted development of MOF within 7 days of hospitalization.
AHRQ-funded; HS017526; HS023901.
Citation: Vogel JA, Newgard CD, Holmes JF .
Validation of the Denver emergency department trauma organ failure score to predict post-injury multiple organ failure.
J Am Coll Surg 2016 Jan;222(1):73-82. doi: 10.1016/j.jamcollsurg.2015.10.010.
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Keywords: Emergency Department, Trauma, Decision Making, Risk, Injuries and Wounds
Snider C, Jiang D, Logsetty S
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
In Winnipeg, Canada, 20% of youth who visit an emergency department with an injury due to violence have a second visit for a subsequent violent injury within 1 year. This study protocol describes a wraparound care model delivered by a support worker with experience with violence, supported by social workers and links to multiple community partners. It has been developed using an integrated knowledge translation approach.
AHRQ-funded; HS016444.
Citation: Snider C, Jiang D, Logsetty S .
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
BMJ Open 2015 May 19;5(5):e008088. doi: 10.1136/bmjopen-2015-008088.
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Keywords: Children/Adolescents, Emergency Department, Injuries and Wounds