National Healthcare Quality and Disparities Report
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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
676 to 700 of 743 Research Studies DisplayedLewis SS, Dicks KV, Chen LF
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The researchers compared time to diagnosis of invasive surgical site infection (SSI) following hip vs knee arthroplasty. They found that time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume. They hypothesized that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis.
AHRQ-funded; HS023866.
Citation: Lewis SS, Dicks KV, Chen LF .
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
Clin Infect Dis 2015 Apr 1;60(7):990-6. doi: 10.1093/cid/ciu975.
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Keywords: Diagnostic Safety and Quality, Healthcare-Associated Infections (HAIs), Orthopedics, Surgery, Injuries and Wounds, Adverse Events
Vogel JA, Haukoos JS, Erickson CL
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
The authors evaluated whether using long-axis or short-axis view during ultrasound-guided internal jugular and subclavian central venous catheterization results in fewer skin breaks, decreased time to cannulation, and fewer posterior wall penetrations. They found the long-axis view for the internal jugular more efficient than the short-axis view with fewer redirections; the long-axis view for subclavian central venous catheterization more efficient with decreased time to cannulation and fewer redirections; the long-axis approach to subclavian central venous catheterization associated with fewer posterior wall penetrations; and the long-axis view for subclavian central venous catheterization and avoiding posterior wall penetrations resulting in fewer central venous catheter-related complications.
AHRQ-funded; HS017526.
Citation: Vogel JA, Haukoos JS, Erickson CL .
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
Crit Care Med 2015 Apr;43(4):832-9. doi: 10.1097/ccm.0000000000000823.
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Keywords: Adverse Events, Comparative Effectiveness, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
Gidengil CA, Predmore Z, Mattke S
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
The purpose of this study was to identify and analyze recently published cases of breast implant-associated anaplastic large cell lymphoma (ALCL), with an emphasis on diagnosis, staging, treatment, and outcomes. The researchers found that, of 54 cases, most patients presented with a seroma, approximately half were associated with the capsule, most presented as stage IE, and all but one case were ALK-negative. Most patients received chemotherapy and radiation therapy, and 11 percent received stem cell transplants. Approximately one-quarter recurred, and 9 percent died.
AHRQ-funded; HS000029.
Citation: Gidengil CA, Predmore Z, Mattke S .
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
Plast Reconstr Surg 2015 Mar;135(3):713-20. doi: 10.1097/prs.0000000000001037.
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Keywords: Adverse Events, Cancer: Breast Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Tarquinio KM, Howell JD, Montgomery V
Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study.
The objective of this study was to evaluate the association of medication selection on specific tracheal intubation–associated events across pediatric intensive care units. It found that fentanyl, midazolam, and ketamine were the most commonly used induction agents, and the majority of tracheal intubations involved neuromuscular blockade. Ketamine use was not associated with lower prevalence of hypotension.
AHRQ-funded; HS022464; HS021583.
Citation: Tarquinio KM, Howell JD, Montgomery V .
Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study.
Pediatr Crit Care Med 2015 Mar;16(3):210-8. doi: 10.1097/pcc.0000000000000319..
Keywords: Children/Adolescents, Patient Safety, Intensive Care Unit (ICU), Adverse Events, Medication
Ott BR, Daiello LA, Dahabreh IJ
Do statins impair cognition? A systematic review and meta-analysis of randomized controlled trials.
The researchers aimed to synthesize randomized clinical trial (RCTs) evidence on the association between statin therapy and cognitive outcomes. Their meta-analysis of cognitive test data from 14 studies failed to show significant adverse effects of statins on all tests of cognition in either cognitively normal subjects or Alzheimer’s disease subjects.
AHRQ-funded; HS017735.
Citation: Ott BR, Daiello LA, Dahabreh IJ .
Do statins impair cognition? A systematic review and meta-analysis of randomized controlled trials.
J Gen Intern Med 2015 Mar;30(3):348-58. doi: 10.1007/s11606-014-3115-3..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Neurological Disorders, Patient-Centered Outcomes Research
Su BY, Ho KC, Rantz MJ
Doppler radar fall activity detection using the wavelet transform.
The authors propose the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. Evaluations based on the data collected in the lab, in the bathrooms, and in the senior residence apartment validate the promising and robust performance of the proposed WT fall activity detector.
AHRQ-funded; HS018477.
Citation: Su BY, Ho KC, Rantz MJ .
Doppler radar fall activity detection using the wavelet transform.
IEEE Trans Biomed Eng 2015 Mar;62(3):865-75. doi: 10.1109/tbme.2014.2367038..
Keywords: Falls, Patient Safety, Adverse Events
Hakkarainen TW, Steele SR, Bastaworous A
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
This study evaluated the association between the administration of postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and anastomotic complication rates using a large cohort of patients in a statewide collaborative study. It found that postoperative NSAIDs were associated with a significantly increased risk for anastomotic complications among patients undergoing nonelective colorectal resection.
AHRQ-funded; HS020025
Citation: Hakkarainen TW, Steele SR, Bastaworous A .
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medication, Surgery, Outcomes, Adverse Events
Chung JW, Ju MH, Kinnier CV
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
The authors discuss problems associated with AHRQ’s Patient Safety Indicator (PS112), Postoperative Venous Thromboembolism such as identifying truly poor-quality hospitals from those that only seem to be poor-quality because of hospital-to-hospital variations in imaging rates for venous thromboembolism (VTE). They call for the development of administrative codes that enable reliable identification and exclusion of sub-clinical VTE from the measure numerator.
AHRQ-funded; HS021857
Citation: Chung JW, Ju MH, Kinnier CV .
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
Ann Surg. 2015 Mar;261(3):443-4. doi: 10.1097/sla.0000000000000850..
Keywords: Quality Indicators (QIs), Blood Clots, Quality of Care, Adverse Events
Olsen MA, Nickel KB, Wallace AE
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
The researchers investigated whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. After analyzing a total of 119,973 hernia repair procedures, they found that the incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction necrosis.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Wallace AE .
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
Infect Control Hosp Epidemiol 2015 Mar;36(3):329-35. doi: 10.1017/ice.2014.44..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk, Patient Safety
Kozminski MA, Kozminski DJ, Roberts WW
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
The researchers sought to document the rate of and risk factors for the rare complication of symptomatic renal hematoma following ureteroscopic lithotripsy (URSL) for renal calculi. They found that, while symptomatic hematoma is a complication of URSL, the rate of such outcome (0.8 percent) is far less than that reported by prior series with extracorporeal shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL).
AHRQ-funded; HS020927.
Citation: Kozminski MA, Kozminski DJ, Roberts WW .
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
J Endourol 2015 Mar;29(3):277-82. doi: 10.1089/end.2014.0176..
Keywords: Kidney Disease and Health, Patient Safety, Risk, Adverse Events
O'Leary KJ, Turner J, Christensen N
The effect of hospitalist discontinuity on adverse events.
The researchers sought to determine the association between hospital physician continuity and the incidence of adverse events (AEs). Based on an analysis including data from 474 hospitalizations, they found that hospitalist physician continuity does not appear to be associated with the incidence of AEs.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Turner J, Christensen N .
The effect of hospitalist discontinuity on adverse events.
J Hosp Med 2015 Mar;10(3):147-51. doi: 10.1002/jhm.2308..
Keywords: Patient Safety, Adverse Events, Hospitalization
Krings JG, Kallogjeri D, Wineland A
Complications following primary and revision transsphenoidal surgeries for pituitary tumors.
This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications.
AHRQ-funded; HS019455.
Citation: Krings JG, Kallogjeri D, Wineland A .
Complications following primary and revision transsphenoidal surgeries for pituitary tumors.
Laryngoscope 2015 Feb;125(2):311-7. doi: 10.1002/lary.24892..
Keywords: Adverse Events, Cancer, Outcomes, Surgery
Turrentine FE, Denlinger CE, Simpson VB
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
The aims of this study were to examine the incidence of anastomotic leaks, a potentially deadly postoperative occurrence following gastrointestinal surgery, to identify risk factors predictive of leaks, and to explore the impact of anastomotic leaks on hospital cost and patient survival. The study demonstrates that anastomotic leaks remain a major source of increased morbidity, mortality, and hospital resource use for gastrointestinal surgery.
AHRQ-funded; HS011913.
Citation: Turrentine FE, Denlinger CE, Simpson VB .
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
J Am Coll Surg 2015 Feb;220(2):195-206. doi: 10.1016/j.jamcollsurg.2014.11.002..
Keywords: Patient Safety, Surgery, Mortality, Healthcare Costs, Adverse Events
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Foglia EE, Ades A, Napolitano N
Factors associated with adverse events during tracheal intubation in the NICU.
This study sought to determine the incidence of adverse tracheal intubation-associated events (TIAEs and to identify factors associated with TIAEs in the NICU. It found that adverse TIAEs occurred in 153 of 701 (22 percent) tracheal intubation encounters. Modifiable risk factors associated with TIAEs identified include intubator training level and use of paralytic medications.
AHRQ-funded; HS021583.
Citation: Foglia EE, Ades A, Napolitano N .
Factors associated with adverse events during tracheal intubation in the NICU.
Neonatology 2015;108(1):23-9. doi: 10.1159/000381252..
Keywords: Patient Safety, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk, Adverse Events
Topaz M, Seger DL, Lai K
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
This paper examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). Allergic reactions included a high proportion of non-immune mediated opioid reactions. The DAI alert override rate was high for immune-mediated and life-threatening reactions. Exact allergy-medication matches were overridden less frequently compared to non-exact matches within allergy groups.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Lai K .
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
Stud Health Technol Inform 2015;216:242-6.
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Keywords: Opioids, Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Medication, Patient Safety, Medical Errors
Clancy C, Fraser I
AHRQ Author: Clancy C, Fraser I
High-quality health care.
This chapter describes the current state of health care quality (including avoidable harms from care); reviews selected efforts to conceptualize, measure, and improve quality; describes how measures are used to guide improvements in care; addresses promising initiatives to improve care; and predicts how the health care landscape will evolve in the coming years.
AHRQ-authored
Citation: Clancy C, Fraser I .
High-quality health care.
In: Knickman J, Kovner AR, editors. Jonas and Kovner's health care delivery in the United States. 11 ed. New York: Springer; 2015. p. 273-96..
Keywords: Quality of Care, Patient Safety, Medical Errors, Adverse Events, Quality Improvement
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Abdelsattar ZM, Krapohl G, Alrahmani L
Postoperative burden of hospital-acquired Clostridium difficile infection.
The researchers studied clostridium dificile infection (CDI) across diverse surgical settings. They found that incidence of postoperative CDI varied by surgical procedure and was associated with higher rates of extended length of stay, emergency room presentations, and readmissions, placing a potentially preventable burden on hospital resources.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Krapohl G, Alrahmani L .
Postoperative burden of hospital-acquired Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jan;36(1):40-6. doi: 10.1017/ice.2014.8.
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Keywords: Surgery, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Adverse Events, Hospitals
White AA, Brock DM, McCotter PI
Risk managers' descriptions of programs to support second victims after adverse events.
The researchers surveyed US members of the American Society for Healthcare Risk Management about the presence, features, and perceived efficacy of their organization’s provider support program. The majority reported that their organization had a support program, but features varied widely and there are substantial opportunities to improve services.
AHRQ-funded; HS019531.
Citation: White AA, Brock DM, McCotter PI .
Risk managers' descriptions of programs to support second victims after adverse events.
J Healthc Risk Manag 2015;34(4):30-40. doi: 10.1002/jhrm.21169..
Keywords: Adverse Events, Patient Safety, Medical Errors, Practice Patterns
Holcomb CN, Graham LA, Richman JS
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
The investigators sought to determine the incremental risk of noncardiac surgery on myocardial infarction (MI) and coronary revascularization following coronary stenting. They found that the incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
J Am Coll Cardiol 2014 Dec 30;64(25):2730-9. doi: 10.1016/j.jacc.2014.09.072.
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Keywords: Adverse Events, Cardiovascular Conditions, Patient-Centered Healthcare, Risk, Surgery
Vaughan Sarrazin MS, Jones M, Mazur A
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
This study evaluated the relative risks of any, gastrointestinal, intracranial, and other bleeding for Veterans Affairs patients who switched to dabigatran after at least 6 months on warfarin. It found that among veterans with atrial fibrillation who switched to dabigatran, dabigatran increased the risk of gastrointestinal hemorrhage by 54% and was not associated with rates of other bleeding or death.
AHRQ-funded; HS021992
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
Am J Med. 2014 Dec;127(12):1179-85. doi: 10.1016/j.amjmed.2014.07.024..
Keywords: Blood Thinners, Adverse Events, Patient Safety
Aterburn D, Powers JD, Toh S
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
A retrospective study of 7,457 patients undergoing laparoscopic bariatric surgery found that patients receiving gastric bypass experienced much greater weight loss than those receiving gastric banding but they had a higher risk of short-term complications and long-term subsequent hospitalizations. However, gastric bypass patients had a lower risk of long-term subsequent intervention procedures than did gastric banding patients.
AHRQ-funded; HS019912
Citation: Aterburn D, Powers JD, Toh S .
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
JAMA Surg. 2014 Dec;149(12):1279-87. doi: 10.1001/jamasurg.2014.1674..
Keywords: Obesity, Surgery, Adverse Events, Patient Safety, Hospitalization
Meeks DW, Meyer AN, Rose B
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
The researchers described outcomes of peer review within the Department of Veterans Affairs (VA) healthcare system and identified opportunities to leverage peer review data for measurement and improvement of safety. Results showed that the most common process contributing to substandard care was 'timing and appropriateness of treatment'; approximately 16% had diagnosis-related performance concerns. The authors concluded that peer review may be a useful tool for healthcare organizations to assess their sharp end clinical performance, particularly safety events related to diagnostic and treatment errors.
AHRQ-funded; HS022087.
Citation: Meeks DW, Meyer AN, Rose B .
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
BMJ Qual Saf 2014 Dec;23(12):1023-30. doi: 10.1136/bmjqs-2014-003239.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Quality Improvement