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
126 to 150 of 207 Research Studies DisplayedRanney ML, Fletcher J, Alter H
A consensus-driven agenda for emergency medicine firearm injury prevention research.
In order to develop an evidence-based research agenda, the researchers identified fifty-nine final emergency medicine-relevant research questions, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some of these questions could be addressed through research conducted in emergency departments; others would require work in other settings.
AHRQ-funded; HS023901.
Citation: Ranney ML, Fletcher J, Alter H .
A consensus-driven agenda for emergency medicine firearm injury prevention research.
Ann Emerg Med 2017 Feb;69(2):227-40. doi: 10.1016/j.annemergmed.2016.08.454.
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Keywords: Emergency Medical Services (EMS), Prevention, Health Services Research (HSR), Injuries and Wounds
Bunnell KL, Zullo AR, Collins C
Methicillin-resistant staphylococcus aureus pneumonia in critically ill trauma and burn patients: a retrospective cohort study.
The authors sought to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU). They found that the 11.4% overall incidence of MRSA pneumonia in the studied trauma-burn cohort was similar to what has been reported in other trauma populations, although MRSA was equally likely to be identified in early- and late-onset pneumonia. They suggested that risk factors other than duration of hospitalization may be important considerations in the decision to initiate MRSA-active empiric therapy for pneumonia in the trauma-burn ICU.
AHRQ-funded; HS022998.
Citation: Bunnell KL, Zullo AR, Collins C .
Methicillin-resistant staphylococcus aureus pneumonia in critically ill trauma and burn patients: a retrospective cohort study.
Surg Infect 2017 Feb/Mar;18(2):196-201. doi: 10.1089/sur.2016.115.
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Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA)
Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. The purpose of this study was to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. The study concluded that standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.
AHRQ-funded; HS018443.
Citation: Lambert P, Chaisson K, Horton S, P, Chaisson K, Horton S .
Reducing acute kidney injury due to contrast material: how nurses can improve patient safety.
Crit Care Nurse 2017 Feb;37(1):13-26. doi: 10.4037/ccn2017178..
Keywords: Adverse Drug Events (ADE), Adverse Events, Injuries and Wounds, Patient Safety, Heart Disease and Health
Cryer C, Miller TR, Lyons RA
AHRQ Author: Steiner CA
Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.
The aim of this paper was to identify diagnoses with estimated high probability of inpatient admission (PrA) for selected developed countries. Its results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen.
AHRQ-authored.
Citation: Cryer C, Miller TR, Lyons RA .
Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.
Inj Prev 2017 Feb;23(1):47-57. doi: 10.1136/injuryprev-2016-042020.
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Keywords: Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP), Hospitalization, Injuries and Wounds
Gans I, Jain A, Sirisreetreerux N
Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.
This study found heterogeneity in the use of single- versus multiple-dose antibiotic prophylaxis for surgical repair of closed long bone fractures. Many surgeons were unsure of current evidence-based recommendations regarding perioperative antibiotic use. Most respondents indicated they would be receptive to high-level evidence regarding the single- versus multiple-dose perioperative prophylactic antibiotics for the treatment of closed long bone fractures.
AHRQ-funded; HS024547.
Citation: Gans I, Jain A, Sirisreetreerux N .
Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.
Patient Saf Surg. 2017 Jan 16;11:2. doi: 10.1186/s13037-016-0118-5.
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Keywords: Injuries and Wounds, Healthcare-Associated Infections (HAIs), Medication, Prevention, Surgery
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Wellbeloved-Stone CA, Weppner JL, Valdez RS
A systematic review of telerehabilitation and mhealth interventions for spinal cord injury.
This systematic review evaluated the previous decade of telerehabilitation and mHealth interventions for spinal cord injury. The heterogeneity of the included studies coupled with a lack of standardized reporting guidelines precluded the development of specific recommendations for future intervention development. Rather, recommendations from this review focus on the need for a wide of range of future research in this domain, with a stronger focus on mobile Health.
AHRQ-funded; HS023849.
Citation: Wellbeloved-Stone CA, Weppner JL, Valdez RS .
A systematic review of telerehabilitation and mhealth interventions for spinal cord injury.
Current Physical Medicine and Rehabilitation Reports 2016 Dec;4(4):295-311. doi: 10.1007/s40141-016-0138-1.
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Keywords: Telehealth, Health Information Technology (HIT), Injuries and Wounds
Thomas GW, Rojas-Murillo S, Hanley JM
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
The researchers determined if 3D radiographic image interpretation can be reliably assessed, and whether this assessment varies by level of training. They concluded that the interpretation of radiographs to discern 3D information is a promising and a relatively unexplored area for surgical skill education and assessment.
AHRQ-funded; HS022077.
Citation: Thomas GW, Rojas-Murillo S, Hanley JM .
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
Iowa Orthop J 2016;36:1-6.
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Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Injuries and Wounds, Imaging, Training
Piper Jenks N, Pardos de la Gandara M, D'Orazio BM
Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York community health centers.
As part of a research collaborative, 6 New York City-area community health centers recruited patients with Skin and Soft Tissue Infections (SSTIs). This study found that although not statistically significant, immigrants had lower rates of Methicillin-Resistant Staphylococcus aureus (MRSA) infections than did native-born participants, and immigrants showed significantly higher rates of Methicillin-Susceptible Staphylococcus aureus (MSSA) wound cultures.
AHRQ-funded; HS021667.
Citation: Piper Jenks N, Pardos de la Gandara M, D'Orazio BM .
Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York community health centers.
Travel Med Infect Dis 2016 Nov - Dec;14(6):551-60. doi: 10.1016/j.tmaid.2016.10.003.
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Keywords: Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Practice-Based Research Network (PBRN), Antibiotics
Krishnan S, Karg PE, Boninger ML
Early detection of pressure ulcer development following traumatic spinal cord injury using inflammatory mediators.
The authors aimed to identify changes in concentrations of inflammatory mediators in plasma and urine after traumatic spinal cord injury and before the occurrence of a first pressure ulcer. They found that an increase in concentration of the chemokine interferon-γ-induced protein in plasma and a decrease in concentration of the cytokine interferon-α in urine were observed before occurrence of a first pressure ulcer compared with matched controls. They concluded that inflammatory mediators should be explored as possible biomarkers for identifying individuals at risk for pressure ulcer formation.
AHRQ-funded; HS022134.
Citation: Krishnan S, Karg PE, Boninger ML .
Early detection of pressure ulcer development following traumatic spinal cord injury using inflammatory mediators.
Arch Phys Med Rehabil 2016 Oct;97(10):1656-62. doi: 10.1016/j.apmr.2016.01.003.
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Keywords: Pressure Ulcers, Healthcare-Associated Infections (HAIs), Injuries and Wounds
Heerman WJ, Perrin EM, Sanders LM
Racial and ethnic differences in injury prevention behaviors among caregivers of infants.
The objective of this study is to evaluate the association between caregiver race/ethnicity and adherence to injury prevention recommendations. It concluded that a high prevalence of non-adherence to recommended injury prevention behaviors is common across racial/ethnic categories for caregivers of infants among a diverse sample of families from low-SES backgrounds.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Perrin EM, Sanders LM .
Racial and ethnic differences in injury prevention behaviors among caregivers of infants.
Am J Prev Med 2016 Oct;51(4):411-8. doi: 10.1016/j.amepre.2016.04.020.
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Keywords: Caregiving, Family Health and History, Injuries and Wounds, Prevention, Racial and Ethnic Minorities
Conlon C, Asch S, Hanson M
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
The researchers described the design of a study that is assessing quality of care for work-associated carpal tunnel syndrome and associations with clinical outcomes and costs. They found that time off work was generally short and related to surgery. They recommended systematic efforts to evaluate and improve quality of medical care for this condition.
AHRQ-funded; HS018982.
Citation: Conlon C, Asch S, Hanson M .
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
Perm J 2016 Fall;20(4):87-95. doi: 10.7812/tpp/15-220.
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Keywords: Healthcare Delivery, Quality of Care, Injuries and Wounds, Neurological Disorders, Patient-Centered Outcomes Research
Taylor LK, Thomas GW, Karam MD
Assessing wire navigation performance in the operating room.
The researchers sought to develop meaningful, objective measures of wire navigation performance in the operating room. They concluded that several video-based metrics were consistent across the 4 video reviewers and are likely to be useful for performance assessment. The tip-apex distance (TAD) measurement was less reliable than previous reports have suggested, but remains a valuable metric of performance.
AHRQ-funded; HS022077.
Citation: Taylor LK, Thomas GW, Karam MD .
Assessing wire navigation performance in the operating room.
J Surg Educ 2016 Sep-Oct;73(5):780-7. doi: 10.1016/j.jsurg.2016.03.018.
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Keywords: Surgery, Provider Performance, Injuries and Wounds, Orthopedics
Berry SD, Lee Y, Zullo AR
Incidence of hip fracture in U.S. nursing homes.
The researchers described the incidence rate (IR) of hip fracture according to age, sex, and race in a nationwide sample of long-stay nursing home residents. They found that the mean age was 84 years, 74.5% were women, 83.9% were white, and 12.0% were black. The overall IR of hip fracture was 2.3/100 person years, which was similar in men and women across age groups. The IR of hip fracture was highest in Native Americans aged 85 years or older, in whites, and during the first 100 days of institutionalization, while the.IRs of hip fracture were lowest in blacks.
AHRQ-funded; HS022998.
Citation: Berry SD, Lee Y, Zullo AR .
Incidence of hip fracture in U.S. nursing homes.
J Gerontol A Biol Sci Med Sci 2016 Sep;71(9):1230-4. doi: 10.1093/gerona/glw034.
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Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Racial and Ethnic Minorities
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Yin MT, Shiau S, Rimland D
Fracture prediction with modified-FRAX in older HIV-infected and uninfected men.
The authors investigated considering HIV as a cause of secondary osteoporosis when calculating FRAX, a clinical fracture risk calculator, in HIV-infected individuals. They found that modified-FRAX underestimated the fracture rates more in older HIV-infected than in otherwise similar uninfected men. and they recommend further studies to determine how to risk stratify for screening and treatment in older HIV-infected individuals.
AHRQ-funded; HS018372.
Citation: Yin MT, Shiau S, Rimland D .
Fracture prediction with modified-FRAX in older HIV-infected and uninfected men.
J Acquir Immune Defic Syndr 2016 Aug 15;72(5):513-20. doi: 10.1097/qai.0000000000000998.
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Keywords: Clinical Decision Support (CDS), Elderly, Injuries and Wounds, Human Immunodeficiency Virus (HIV), Risk
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Bali V, Chatterjee S, Johnson ML
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
The researchers evaluated comparative safety of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) for the risk of hip fractures. They found no differential risk of hip fractures between paroxetine and other SSRIs.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Johnson ML .
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
J Comp Eff Res 2016 Aug;5(5):461-73. doi: 10.2217/cer-2016-0009.
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Keywords: Medication, Elderly, Injuries and Wounds, Nursing Homes, Patient Safety
Rinke ML, Jan D, Nassim J
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
The authors identified surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. They concluded that SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children.
AHRQ-funded; HS021282.
Citation: Rinke ML, Jan D, Nassim J .
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
Infect Control Hosp Epidemiol 2016 Aug;37(8):931-8. doi: 10.1017/ice.2016.98.
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Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk
Bowling CB, Bromfield SG, Colantonio LD
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
The researchers studied adverse outcomes in patients on dialysis as a result of falls. They found that among participants with CKD, cumulative 1-year mortality rates among patients with a serious fall and age-matched controls were 21.0% and 5.5%, respectively, and noted that elevated ACR but not lower eGFR was associated with serious fall injuries. They concluded that evaluation for fall risk factors and fall prevention strategies should be considered for older adults with elevated ACR.
AHRQ-funded; HS023009.
Citation: Bowling CB, Bromfield SG, Colantonio LD .
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
Clin J Am Soc Nephrol 2016 Jul 7;11(7):1236-43. doi: 10.2215/cjn.11111015.
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Keywords: Elderly, Falls, Patient-Centered Outcomes Research, Kidney Disease and Health, Injuries and Wounds
Hoffman GJ, Hays RD, Shapiro MF
Claims-based identification methods and the cost of fall-related injuries among US older adults.
The authors compared expenditures of fall-related injuries (FRIs) using several methods to identify FRIs in administrative claims data. They found that most spending occurred in hospital, outpatient, and skilled nursing facility settings, and that inpatient-treated FRIs were substantially higher when identifying FRI using only e-codes. They concluded that expenditure estimates vary considerably based on the method used to identify FRIs.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Shapiro MF .
Claims-based identification methods and the cost of fall-related injuries among US older adults.
Med Care 2016 Jul;54(7):664-71. doi: 10.1097/mlr.0000000000000531.
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Keywords: Elderly, Falls, Healthcare Costs, Injuries and Wounds, Patient Safety
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
Wiseman JT, Fernandes-Taylor S, Gunter R
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
The authors evaluated whether smartphone digital images can supplant in-person evaluation of postoperative vascular surgery wounds. They concluded that using smartphone digital images is a valid method for evaluating postoperative vascular surgery wounds and is comparable to in-person evaluation with regard to most wound characteristics. The inter-rater reliability for determining treatment recommendations was universally high.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Gunter R .
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
J Vasc Surg Venous Lymphat Disord 2016 Jul;4(3):320-28.e2. doi: 10.1016/j.jvsv.2016.02.001.
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Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Telehealth, Surgery, Health Information Technology (HIT), Diagnostic Safety and Quality
Roberts ET, DuGoff EH, Heins SE
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
The researchers examined the association between non-adherence to clinical practice guidelines (CPGs) and time to return to work (RTW) for patients with workplace injuries. They found that early receipt of care and getting less than the recommended amount of care were correlated with faster RTW, while excessive physical therapy, bracing, and injections were associated with slower RTW. They recommended that CPGs supported by observational studies or randomized trials may have a more certain relationship to health outcomes.
AHRQ-funded; HS000029.
Citation: Roberts ET, DuGoff EH, Heins SE .
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
Health Serv Res 2016 Jun;51(3):953-80. doi: 10.1111/1475-6773.12360.
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Keywords: Guidelines, Injuries and Wounds, Patient-Centered Outcomes Research
Nickel KB, Fox IK, Margenthaler JA
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
The authors determined the rates of noninfectious wound complications (NIWCs) among women undergoing mastectomy and assessed the impact of immediate reconstruction (IR). They found that the rate of NIWC was approximately 2-fold higher after mastectomy with IR than after mastectomy only and that noninfectious wound complications were associated with additional surgical treatment, particularly in women with implant reconstruction, and with early implant loss.
AHRQ-funded; HS019455.
Citation: Nickel KB, Fox IK, Margenthaler JA .
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
J Am Coll Surg 2016 May;222(5):844-52.e1. doi: 10.1016/j.jamcollsurg.2016.01.050.
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Keywords: Adverse Events, Cancer: Breast Cancer, Injuries and Wounds, Surgery