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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
651 to 675 of 737 Research Studies DisplayedGonzalez AA, Abdelsattar ZM, Dimick JB
Time-to-readmission and mortality after high-risk surgery.
This study used 5 years of data on Medicare beneficiaries undergoing high-risk surgical procedures to investigate whether postdischarge mortality varies by time to readmission. It found that surgical readmissions within 10 days of discharge are disproportionately common and associated with increased mortality independent of index complications.
AHRQ-funded; HS017765; HS000053.
Citation: Gonzalez AA, Abdelsattar ZM, Dimick JB .
Time-to-readmission and mortality after high-risk surgery.
Ann Surg 2015 Jul;262(1):53-9. doi: 10.1097/sla.0000000000000912..
Keywords: Patient Safety, Mortality, Hospital Readmissions, Adverse Events, Surgery
Sage WM, Jablonski JS, Thomas EJ
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
The researchers sought to determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. They found that an academic health system with a declared commitment to patient safety and transparency used nondisclosure clauses in most malpractice settlement agreements but with little standardization or consistency.
AHRQ-funded; HS019561.
Citation: Sage WM, Jablonski JS, Thomas EJ .
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
JAMA Intern Med 2015 Jul;175(7):1130-5. doi: 10.1001/jamainternmed.2015.1035..
Keywords: Adverse Events, Medical Errors, Medical Liability, Patient Safety
Abdelsattar ZM, Hendren S, Wong SL
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
The researchers assessed the hospital-level variation in transfusion practices for packed red blood cells and the patient-level effects on outcomes after noncardiac general or vascular surgery, using population-based prospectively collected data. They found that postoperative transfusions after noncardiac surgery are associated with increased adverse postoperative outcomes, with the exception of postoperative myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
Ann Surg 2015 Jul;262(1):1-6. doi: 10.1097/sla.0000000000001264..
Keywords: Patient Safety, Surgery, Outcomes, Adverse Events
Manojlovich M, Adler-Milstein J, Harrod M
The effect of health information technology on health care provider communication: a mixed-method protocol.
The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians. It seeks to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, and (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Adler-Milstein J, Harrod M .
The effect of health information technology on health care provider communication: a mixed-method protocol.
JMIR Res Protoc 2015 Jun 11;4(2):e72. doi: 10.2196/resprot.4463..
Keywords: Adverse Events, Communication, Health Information Technology (HIT), Patient Safety, Medical Errors
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
Because laboratory testing and coding for rotavirus are not routinely performed for patients with diarrhea, the researchers examined both all-cause acute gastroenteritis and rotavirus-coded hospitalizations among children younger than 5 years from 2000 through 2012. They found that, in 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations.
AHRQ-authored.
Citation: Leshem E, Tate JE, Steiner CA .
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
JAMA 2015 Jun 9;313(22):2282-4. doi: 10.1001/jama.2015.5571..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination, Children/Adolescents, Adverse Events
Nuckols TK, Smith-Spangler C, Morton SC
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
The primary objective of this systematic review and meta-analysis study was to quantitatively assess the effectiveness of computerized provider order entry (CPOE) at reducing preventable adverse drug events (pADE). It found that CPOE is associated with cutting in half the number of pADEs. Medication errors were also about half as common with CPOE.
AHRQ-funded; HS017954
Citation: Nuckols TK, Smith-Spangler C, Morton SC .
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
Syst Rev. 2014 Jun 4;3:56. doi: 10.1186/2046-4053-3-56..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety
Stockwell DC, Bisarya H, Classen DC
A trigger tool to detect harm in pediatric inpatient settings.
The researchers developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments. After reviewing review 100 randomly selected inpatient records from each of 6 academic children’s hospitals, they found that the most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications.
AHRQ-funded; HS020513.
Citation: Stockwell DC, Bisarya H, Classen DC .
A trigger tool to detect harm in pediatric inpatient settings.
Pediatrics 2015 Jun;135(6):1036-42. doi: 10.1542/peds.2014-2152..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Children/Adolescents, Adverse Events
Frasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL
Maternal age and risk of labor and delivery complications.
The researchers examined associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Using HCUP data, they found that complications with the highest odds among women 11-18 years of age included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women 35 and older had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Women over 40 had increased odds for mild preeclampsia, fetal distress, and poor fetal growth.
AHRQ-funded; HS019455.
Citation: Cavazos-Rehg PA, Krauss MJ, Spitznagel EL .
Maternal age and risk of labor and delivery complications.
Matern Child Health J 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
Reiter-Palmon R, Kennel V, Allen JA
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
In this study, the authors added to our understanding of Naturalistic Decision Making (NDM) in healthcare and how After Action Reviews (AARs) can be utilized as a learning tool to reduce errors. They found that the use of self-guided post-fall huddles increased over the time of the project, the types of errors identified as contributing to the patient fall changed, and the proportion of falls with less adverse effects increased during the project time period. They concluded that , over time, self-guided AARs can be useful for some aspects of learning from errors.
AHRQ-funded; HS021429.
Citation: Reiter-Palmon R, Kennel V, Allen JA .
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
J Occup Organ Psychol 2015 Jun;88(2):322-40. doi: 10.1111/joop.12084.
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Keywords: Adverse Events, Falls, Decision Making, Medical Errors, Patient Safety
Saeed MJ, Dubberke ER, Fraser VJ
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous National Healthcare Safety Network surgery categories (amputation; bile duct, liver or pancreas; breast; colon; and hernia) in community hospitals in California, Florida, and New York. The 90-day SSI rates varied significantly within each of the 5 subgroups.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Dubberke ER, Fraser VJ .
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
Am J Infect Control 2015 Jun;43(6):617-23. doi: 10.1016/j.ajic.2015.02.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Patient Safety, Adverse Events
Walker J, Tucker LY, Goodney P
Adherence to endovascular aortic aneurysm repair device instructions for use guidelines has no impact on outcomes.
The authors reported on their long-term endovascular aortic aneurysm repair (EVAR) experience in a large multicenter registry with regard to adherence to instructions for use (IFU) guidelines. They found that overall mortality and aneurysm-related mortality were unaffected by IFU adherence, and that rates of endoleak and reintervention after initial EVAR were similar, suggesting that lack of IFU-based anatomic suitability was not a driver of outcomes.
AHRQ-funded; HS021581.
Citation: Walker J, Tucker LY, Goodney P .
Adherence to endovascular aortic aneurysm repair device instructions for use guidelines has no impact on outcomes.
J Vasc Surg 2015 May;61(5):1151-9. doi: 10.1016/j.jvs.2014.12.053.
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Keywords: Adverse Events, Guidelines, Medical Devices, Outcomes
Camelo Castillo W, Boggess K, Sturmer T
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
The purpose of this study was to estimate the risks of adverse pregnancy outcomes among women receiving glyburide compared with insulin for the treatment of gestational diabetes mellitus (GDM) in a US population-based cohort. It found an association between glyburide (compared with insulin) and elevated risk of NICU admission, neonatal hypoglycemia, respiratory distress, birth injury, and large for gestational age in women with GDM.
AHRQ-funded; HS017950.
Citation: Camelo Castillo W, Boggess K, Sturmer T .
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
JAMA Pediatr 2015 May;169(5):452-8. doi: 10.1001/jamapediatrics.2015.74..
Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Diabetes, Labor and Delivery, Maternal Care, Medication, Newborns/Infants, Outcomes, Pregnancy, Women
Singh JA, Ramachandran R
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
The researchers assessed the association of hospital procedure volume for total shoulder arthroplasty (TSA) with patient outcomes and complications. They found that, compared to low volume hospitals (<5, 5–9, or 10–14 procedures annually), patients receiving TSA at higher volume hospitals (15–24 or ‡25 procedures annually) had significantly lower likelihood of being discharged to an inpatient medical facility.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
Arthritis Care Res 2015 May;67(6):885-90. doi: 10.1002/acr.22507..
Keywords: Patient-Centered Outcomes Research, Adverse Events, Patient Safety, Quality of Care, Healthcare Cost and Utilization Project (HCUP)
Hernandez-Boussard T, McDonald KM, Rhoads KF
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
The study’s aim was to assess risk-adjusted rates of inpatient adverse events (AEs) for general reconstructive soft tissue procedures using established measures. It found that plastic surgery patients had a significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, McDonald KM, Rhoads KF .
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
Ann Plast Surg 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Inpatient Care, Hospitalization, Patient Safety
Roxbury CR, Yang J, Salazar J
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
This study described safety and postoperative sequelae of pediatric otologic surgery and identify predictive factors for postoperative events. It found that pediatric otologic procedures are common and have low rates of global 30-day postoperative events. Tympanomastoidectomy and cochlear implantation have the highest risk of 30-day readmission.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Yang J, Salazar J .
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
Otolaryngol Head Neck Surg 2015 May;152(5):790-5. doi: 10.1177/0194599815575711..
Keywords: Adverse Events, Children/Adolescents, Surgery, Patient Safety, Children/Adolescents, Quality Improvement
Albrecht JS, Marcantonio ER, Roffey DM
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
This paper's objectives were to determine the stability of psychomotor subtypes of delirium over time and to identify characteristics associated with delirium psychomotor subtypes in individuals undergoing surgical repair of hip fracture. The Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair Cognitive Ancillary Study was conducted. Results showed that psychomotor subtypes of delirium often fluctuated from assessment to assessment, rather than representing fixed categories of delirium. Hypoactive delirium was the most common presentation of delirium but the least likely to be documented by healthcare providers.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Marcantonio ER, Roffey DM .
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
J Am Geriatr Soc 2015 May;63(5):970-6. doi: 10.1111/jgs.13334.
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Keywords: Adverse Events, Cardiovascular Conditions, Injuries and Wounds, Neurological Disorders, Surgery
Malhotra J, Mhango G, Gomez JE
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
The researchers compared overall survival and rates of serious adverse events (defined as those requiring admission to hospital) between patients treated with resection alone, platinum-based adjuvant chemotherapy, or postoperative radiation (PORT) with or without adjuvant chemotherapy. Platinum-based adjuvant chemotherapy is associated with reduced mortality and increased serious adverse events in elderly patients with stage I non-small-cell lung cancer ≥4 cm in size.
AHRQ-funded; HS019670.
Citation: Malhotra J, Mhango G, Gomez JE .
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
Ann Oncol 2015 Apr;26(4):768-73. doi: 10.1093/annonc/mdv008..
Keywords: Cancer: Lung Cancer, Elderly, Treatments, Adverse Events, Comparative Effectiveness
Sharma G, Meena R, Goodwin JS
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
The researchers quantified the risk of burn injury associated with home oxygen use and examined the risk factors associated with the development of this injury. They found that the absolute risk of burn injury in patients prescribed oxygen therapy was 2.98 per 1000 patients compared with 1.69 per 1000 patients not prescribed oxygen during a 22-month period.
AHRQ-funded; HS020642; HS022134.
Citation: Sharma G, Meena R, Goodwin JS .
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
Mayo Clin Proc 2015 Apr;90(4):492-9. doi: 10.1016/j.mayocp.2014.12.024..
Keywords: Injuries and Wounds, Adverse Events, Risk, Respiratory Conditions, Elderly
Lewis 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