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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
201 to 225 of 367 Research Studies DisplayedSanders R, Edwards L, Nishisaki A
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
This editorial discusses a research study on outcomes of performing pediatric trachael intubations (TIs) and how the results can be applied to performing intubations on critically ill children in the United Kingdom outside of specialized centers. One of the authors is from a U.S. site that submits its airway management data to the National Emergency Airway Registry for Children (NEAR4KIDS). The results from the registry were compared to the results from the study. A total of 1,051 patients out of 1,237 eligible patients were analyzed. The results came from 47 nonspecialized local hospitals in the North Thames and East Anglia region of the UK. Adverse TI-associated events (TIAEs) occurred in 22.7% of the patients, which is higher than those in PICUs and cardiac ICUs. The majority of intubations were performed by the anesthesiologist in the team. The results were similar to those in the NEAR4KIDS registry. There were more complications with children with a higher grade of airway difficulties and comorbidities. The authors believe that pediatric airway management for acutely ill children would benefit from new strategies. They recommend a system change using Plan, Do, Study, Act (PDSA) cycles.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Sanders R, Edwards L, Nishisaki A .
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
Pediatr Crit Care Med 2019 Jun;20(6):572-73. doi: 10.1097/pcc.0000000000001946..
Keywords: Adverse Events, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Outcomes, Patient Safety, Registries, Respiratory Conditions
Shaker M, Greenhawt M
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
The goal of this study was to evaluate critical inputs associated with the cost-effectiveness of epicutaneous peanut immunotherapy (EPIT) and peanut oral immunotherapy (POIT) from a societal perspective. In microsimulations with Markov modeling, virtual children aged 4 years over received EPIT, POIT, or no immunotherapy treatment. The main outcomes and measures were rates of therapy-associated adverse reactions; quality-of-life improvements associated with changes in tolerated peanut doses were modeled along with quality-adjusted life-years (QALY), anaphylaxis, therapy-associated anaphylaxis, and fatalities. The findings of this simulated analysis indicate that EPIT and POIT may be cost-effective, but the authors note that further research is needed.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
JAMA Netw Open 2019 May 3;2(5):e193242. doi: 10.1001/jamanetworkopen.2019.3242..
Keywords: Healthcare Costs, Outcomes, Respiratory Conditions, Treatments
Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH
AHRQ Author: Elixhauser A
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Pneumonia is a leading cause of pediatric admissions. Although air pollutants are associated with poor outcomes, few national studies have examined associations between pollutant levels and inpatient pediatric pneumonia outcomes. In this study, the investigators examined the relationship between ozone (O3) and fine particulate matter with a diameter </=2.5 microm (PM2.5) and outcomes related to disease severity. They concluded that greater levels of O3 and PM2.5 were associated with more severe presentations of pneumonia.
AHRQ-authored
Citation: Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH .
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Acad Pediatr 2019 May - Jun;19(4):414-20. doi: 10.1016/j.acap.2018.12.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Hospitalization, Outcomes
Russell FM, Ehman RR, Ferre R
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Medical treatment for acute heart failure (AHF) has not changed substantially over the last four decades. Emergency department (ED)-based evidence for treatment is limited. The investigators discuss BLUSHED-AHF, a multicenter, randomized, pilot trial designed to test whether a strategy of care that utilizes a LUS-driven treatment protocol outperforms usual care for reducing pulmonary congestion in the ED.
AHRQ-funded; HS025411.
Citation: Russell FM, Ehman RR, Ferre R .
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Heart Lung 2019 May - Jun;48(3):186-92. doi: 10.1016/j.hrtlng.2018.10.027..
Keywords: Emergency Department, Heart Disease and Health, Cardiovascular Conditions, Imaging, Respiratory Conditions
Forrest CB, Zorc JJ, Moon J
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
The purpose of this study was to evaluate the reliability and validity of the PROMIS Pediatric Global Health scale, a 7-item measure of perceived physical, mental, and social health, in children with asthma. The investigators concluded that the PGH-7 is a reliable and valid patient-reported outcome for assessing general health among children with asthma. It is a useful complement to other asthma-specific outcome measures.
AHRQ-funded; HS020508.
Citation: Forrest CB, Zorc JJ, Moon J .
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
J Asthma 2019 May;56(5):534-42. doi: 10.1080/02770903.2018.1471701..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Health Status
Kenyon CC, Gruschow SM, Haaland WL
Kenyon CC, Gruschow SM, Haaland WL, Desai AD, Adams SA, Hitt TA, Williams DJ, et al. Perceived access to outpatient care and hospital reutilization following acute respiratory illnesses.
The authors’ goal was to assess the relationship between perceived access to timely office-based care and subsequent 30-day pediatric revisits following hospital discharge for asthma, bronchiolitis, croup, and pneumonia. They found that perceived access to timely office-based care was associated with significantly greater odds of subsequent emergency department revisit. They concluded that focusing solely on enhancing timely access to care following discharge for common respiratory illnesses may be insufficient to prevent repeat utilization.
AHRQ-funded; HS024299.
Citation: Kenyon CC, Gruschow SM, Haaland WL .
Kenyon CC, Gruschow SM, Haaland WL, Desai AD, Adams SA, Hitt TA, Williams DJ, et al. Perceived access to outpatient care and hospital reutilization following acute respiratory illnesses.
Acad Pediatr 2019 May - Jun;19(4):370-77. doi: 10.1016/j.acap.2018.07.001..
Keywords: Children/Adolescents, Respiratory Conditions, Ambulatory Care and Surgery, Emergency Department, Access to Care, Hospitals
Patel SM, Spees L, Smieja M
Patel SM, Spees L, Smieja M, Luinstra K, Steenhoff AP, Feemster KA, Arscott-Mills T, et al. Predictors of poor outcomes among infants with respiratory syncytial virus-associated acute lower respiratory infection in Botswana.
This article examined predictors of poor outcomes among infants with respiratory syncytial virus-associated acute lower respiratory infection in Botswana. Among children 1-23 months of age with respiratory syncytial virus-associated acute lower respiratory infection in Botswana, young age (<6 months), household use of wood as a cooking fuel, moderate or severe malnutrition and oxygen saturation <90% on room air were independent predictors of clinical nonresponse at 48 hours.
AHRQ-funded; HS000032.
Citation: Patel SM, Spees L, Smieja M .
Patel SM, Spees L, Smieja M, Luinstra K, Steenhoff AP, Feemster KA, Arscott-Mills T, et al. Predictors of poor outcomes among infants with respiratory syncytial virus-associated acute lower respiratory infection in Botswana.
Pediatr Infect Dis J 2019 May;38(5):525-27. doi: 10.1097/inf.0000000000002168..
Keywords: Newborns/Infants, Respiratory Conditions, Outcomes
Myers LC, Faridi MK, Currier P
ICU utilization for patients with acute exacerbation of chronic obstructive pulmonary disease receiving noninvasive ventilation.
This retrospective cohort study investigated whether patients with chronic obstructive pulmonary disease (COPD) could safely receive noninvasive ventilation outside of ICU. Researchers examined 5,081 hospitalizations from 424 hospitals, using data from the State Inpatient Database. Researchers concluded that COPD patients who receive noninvasive ventilation had similar in-hospital mortality rates across the ICU utilization spectrum, but a lower rate of receiving invasive monitors. The results suggest that noninvasive ventilation can be delivered safely outside of ICU, but the researchers advocate that hospital-specific risk assessment be used if a hospital is considering changing its noninvasive ventilation policy.
AHRQ-funded; HS23305.
Citation: Myers LC, Faridi MK, Currier P .
ICU utilization for patients with acute exacerbation of chronic obstructive pulmonary disease receiving noninvasive ventilation.
Crit Care Med 2019 May;47(5):677-884. doi: 10.1097/ccm.0000000000003660..
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Intensive Care Unit (ICU)
Wheatley LM, Wood R, Nadeau K
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
A joint AHRQ and National Institute of Allergy and Infectious Diseases (NIAAD) workshop was held to develop trial concepts that could improve the use and effectiveness of aeroallergen immunotherapy (AAIT). Four different expert groups were formed to propose different study designs. These study designs would create clinical trials of long duration and would need highly characterized patient populations.
AHRQ-funded; 290200710061I.
Citation: Wheatley LM, Wood R, Nadeau K .
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
J Allergy Clin Immunol 2019 May;143(5):1711-26. doi: 10.1016/j.jaci.2019.01.032..
Keywords: Asthma, Comparative Effectiveness, Evidence-Based Practice, Prevention, Research Methodologies, Respiratory Conditions
Vashakidze SA, Kempker JA, Jakobia NA
Pulmonary function and respiratory health after successful treatment of drug-resistant tuberculosis.
This cross-sectional study examined outcomes of patients successfully treated for drug-resistant tuberculosis (DR-TB) in Tbilisi, Georgia. Participants had a chest X-ray, St. George Respiratory Quality (SGRQ) survey, and pulmonary function tests (PFTs). Median follow-up tie was 41 months for the 58 subjects. A high proportion of subjects had residual pulmonary impairment, especially if this was a recurrence of TB or severe radiological disease. Patients who underwent surgical resection (47%) showed improved lung function.
AHRQ-funded; HS025240.
Citation: Vashakidze SA, Kempker JA, Jakobia NA .
Pulmonary function and respiratory health after successful treatment of drug-resistant tuberculosis.
Int J Infect Dis 2019 May;82:66-72. doi: 10.1016/j.ijid.2019.02.039..
Keywords: Medication, Outcomes, Respiratory Conditions
Louisias M, Ramadan A, Naja AS
The effects of the environment on asthma disease activity.
This study discusses environmental factors that trigger or aggravate symptoms of asthma in children. Biological and physical factors include allergens, microbiome, endotoxin, genetics and pollution. Psychosocial environmental factors include stress, neighborhood safety, housing and discrimination. Control of these factors help to reduce prevalence and severity of asthma.
AHRQ-funded; HS022986.
Citation: Louisias M, Ramadan A, Naja AS .
The effects of the environment on asthma disease activity.
Immunol Allergy Clin North Am 2019 May;39(2):163-75. doi: 10.1016/j.iac.2018.12.005..
Keywords: Asthma, Children/Adolescents, Respiratory Conditions, Risk, Social Determinants of Health
Wickwire EM, Albrecht JS, Towe MM
The impact of treatments for OSA on monetized health economic outcomes: a systematic review.
This article systematically reviews published literature on the impact of treatment for obstructive sleep apnea (OSA) on monetized health economic outcomes. Customized searches were conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases; 196 articles were selected for review, and 17 studies met the inclusion criteria and were included in the final synthesis. In these selected studies, positive airway pressure was the most common treatment modality, but oral appliances and surgical approaches were also included. Healthcare use (HCU) and quality-adjusted life years (QALYs) were most common health economic outcomes. The authors conclude that, although study methodologies varied widely, the evidence suggested that treatment of OSA was associated with favorable economic outcomes within accepted ranges of cost-effectiveness, as well as reduced HCU and monetized costs.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Albrecht JS, Towe MM .
The impact of treatments for OSA on monetized health economic outcomes: a systematic review.
Chest 2019 May;155(5):947-61. doi: 10.1016/j.chest.2019.01.009..
Keywords: Sleep Problems, Respiratory Conditions, Healthcare Costs, Outcomes
Wiese AD, Griffin MR, Grijalva CG
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
In this study, the investigators described the existing evidence for both the direct and indirect impact of Pneumococcal conjugate vaccines (PCVs) on pneumonia among children and adults in the US since PCV introduction. The introduction of PCVs into the US routine infant vaccination schedule led to important reductions in the burden of invasive pneumococcal diseases and non-invasive pneumonia among vaccinated and unvaccinated populations. The impact of direct vaccination of older adults in the US since 2014, though difficult to quantify, is currently being evaluated.
AHRQ-funded; HS022342.
Citation: Wiese AD, Griffin MR, Grijalva CG .
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
Expert Rev Vaccines 2019 Apr;18(4):327-41. doi: 10.1080/14760584.2019.1582337..
Keywords: Vaccination, Pneumonia, Respiratory Conditions, Hospitalization, Prevention
Berry JG, Goodman DM, Coller RJ
Association of home respiratory equipment and supply use with health care resource utilization in children.
The purpose of this cohort study was to compare health care use and spending in children using vs not using respiratory medical equipment and supplies (RMES). The investigators found that the use of RMES was associated with high health care spending, especially with hospital and home health care. They suggest that population health initiatives in children may benefit from consideration of RMES in comprehensive risk assessment for health care spending.
AHRQ-funded; HS02513.
Citation: Berry JG, Goodman DM, Coller RJ .
Association of home respiratory equipment and supply use with health care resource utilization in children.
J Pediatr 2019 Apr;207:169-75.e2. doi: 10.1016/j.jpeds.2018.11.046..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Home Healthcare, Respiratory Conditions
Singh G, Agarwal A, Zhang W
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
This retrospective cohort study analyzed data from a national sample of fee-for-service Medicare beneficiaries with a diagnosis of chronic obstructive pulmonary disease (COPD) and coexisting obstructive sleep apnea (OSA) who had begun positive airway pressure (PAP) therapy in 2011. The effect of PAP therapy on emergency room visits and hospitalizations for all-cause and COPD-related conditions was also examined. PAP therapy was more beneficial for older adults, those with higher COPD complexity, and those with three or more comorbidities. PAP therapy in elderly patients with overlap syndrome is associated with a reduction in hospitalization for COPD-related conditions, but not for all-cause hospitalizations or ER visits.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Agarwal A, Zhang W .
Impact of PAP therapy on hospitalization rates in Medicare beneficiaries with COPD and coexisting OSA.
Sleep Breath 2019 Mar;23(1):193-200. doi: 10.1007/s11325-018-1680-0..
Keywords: Respiratory Conditions, Sleep Problems, Hospitalization, Medicare, Chronic Conditions
Iyer AS, Holm KE, Bhatt SP
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
This study compared the frequency of anxiety/depressive symptoms of current and former smokers with and without COPD and their use of anxiolytic-hypnotics/antidepressants. A cohort of 5331 current/former smokers were surveyed. About 25% of smokers with and without COPD had anxiety/depressive symptoms. Unmedicated smokers tended to be African American, male, have no health insurance, have severe-very severe COPD and higher respiratory symptoms/exacerbation history.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Holm KE, Bhatt SP .
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
J Psychosom Res 2019 Mar;118:18-26. doi: 10.1016/j.jpsychores.2019.01.002..
Keywords: Anxiety, Medication, Respiratory Conditions, Depression, Behavioral Health, Anxiety, Tobacco Use
Kang M, Kempker JA
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
This case definition introduces challenges to the reliable and accurate epidemiologic study of acute respiratory distress syndrome (ARDS). Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
AHRQ-funded; HS025240.
Citation: Kang M, Kempker JA .
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
Semin Respir Crit Care Med 2019 Feb;40(1):3-11. doi: 10.1055/s-0039-1683884..
Keywords: Disparities, Respiratory Conditions, Chronic Conditions, Risk
Louisias M, Wright L, Phipatanakul W
Asthma in the melting pot.
This article highlights research advances related to asthma health disparities, and offers recommendations regarding innovative approaches to achieve equity and social justice for minority and low-income populations. Since traditional randomized controlled trials may not always be the most appropriate approach to health disparities research interventions, the authors suggest appropriate alternatives, such as the stepped-wedge design; or, because intervention trials are not always feasible, alternative analytic approaches such as mediation analysis or modeling could be used instead. Dissemination and implementation (D&I) research and the use of biomarkers to measure the social disadvantage impact of asthma outcomes are also discussed.
AHRQ-funded; HS022986.
Citation: Louisias M, Wright L, Phipatanakul W .
Asthma in the melting pot.
Ann Allergy Asthma Immunol 2019 Feb;122(2):136-39. doi: 10.1016/j.anai.2018.11.009.
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Keywords: Asthma, Disparities, Respiratory Conditions, Low-Income, Racial and Ethnic Minorities
Kamil RJ, Roxbury C, Boss E
Pediatric rhinoplasty: a national surgical quality improvement program analysis.
Rhinoplasty is commonly performed in children with congenital anomalies and resultant nasal deformity causing airway obstruction. Little is known regarding patient factors or perioperative sequelae. In this retrospective cohort study, the investigators define demographic characteristics and perioperative complications for children undergoing rhinoplasty within a large national cohort. The investigators concluded that children undergoing rhinoplasty experienced few major complications, with the most common being unplanned readmission.
AHRQ-funded; HS022932.
Citation: Kamil RJ, Roxbury C, Boss E .
Pediatric rhinoplasty: a national surgical quality improvement program analysis.
Laryngoscope 2019 Feb;129(2):494-99. doi: 10.1002/lary.27304..
Keywords: Children/Adolescents, Respiratory Conditions, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research
Brunwasser SM, Slavich GM, Newcomb DC
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Prenatal life stress exposure is linked to dysregulated immune function and chronic inflammatory disease in offspring, but little is known about its effects on infant immune response during viral infection. To address this issue, the investigators examined associations between prenatal life stress exposure and infant upper-airway inflammatory markers during acute respiratory infection (ARI) using data from a prospective, population-based birth-cohort study (N=180).
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Slavich GM, Newcomb DC .
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Brain Behav Immun 2019 Feb;76:275-79. doi: 10.1016/j.bbi.2018.12.002..
Keywords: Respiratory Conditions, Stress, Women
Mokhateb-Rafii T, Bakar A, Gangadharan S
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
The objective of this study was to determine a level of oxygen desaturation associated with increased risk of tracheal intubation events in children in a pediatric or cardiac ICU with cyanotic and noncyanotic heart disease. Oxygen desaturation was measured by a fall in pulse oximetry from baseline after pre-oxygenation. The primary outcome was occurrence of hemodynamic tracheal intubation associated events defined as cardiac arrest, hypotension, or dysrhythmia. Results indicate that oxygen desaturation by 30% or more is associated with increased odds for adverse hemodynamic events, after adjusting for confounders. Oxygen desaturation was observed more often in children with cyanotic than those with noncyanotic heart disease, but hemodynamic tracheal intubation associated event rates were similar.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Mokhateb-Rafii T, Bakar A, Gangadharan S .
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
Pediatr Crit Care Med 2019 Jan;20(1):19-26. doi: 10.1097/pcc.0000000000001766..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Heart Disease and Health, Respiratory Conditions, Intensive Care Unit (ICU), Patient Safety, Risk
Starr P, Agarwal A, Singh G
Obstructive sleep apnea with chronic obstructive pulmonary disease among Medicare beneficiaries.
This research letter describes a claims-based study of Medicare beneficiaries conducted by the authors that examined the diagnosed prevalence and trend of overlap syndrome (the coexistence of chronic obstructive pulmonary disease [COPD] and obstructive sleep apnea [OSA] in a single individual). A total of 159,084 patients with COPD were included in the study; 11 percent had coexisting OSA. Data were gathered from multiple files: the Medicare Denominator File, the Medicare Provider Analysis and Review File, the Outpatient Standard Analytic File, the 100% Physician/Supplier Data File, and the Durable Medical Equipment File. Medicare enrollment files were used to gather information on patient characteristics and categorize subjects by age, sex, race, and socioeconomic status. The authors note that the prevalence of diagnosed overlap syndrome has increased fourfold during the 10-year study period.
AHRQ-funded; HS020642; HS022134.
Citation: Starr P, Agarwal A, Singh G .
Obstructive sleep apnea with chronic obstructive pulmonary disease among Medicare beneficiaries.
Ann Am Thorac Soc 2019 Jan;16(1):153-56. doi: 10.1513/AnnalsATS.201712-932OC..
Keywords: Sleep Problems, Respiratory Conditions, Medicare, Chronic Conditions
Lee JH, Nuthall G, Ikeyama T
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Researchers hypothesized that there would be differences in the process of care and adverse outcomes for tracheal intubation across pediatric ICUs (PICUs) in six different geographical regions: Germany, Japan, Singapore, India, New Zealand, and North America. Adverse tracheal intubation-associated events and desaturation occurrences in PICUS in these regions were evaluated, and the international PICUs compared with those in North America. The proportion of tracheal intubations for endotracheal tube change was greater in international PICUs, and the median age for international tracheal intubations was younger when compared with North America PICUs. Occurrences of adverse tracheal intubation-associated events were slightly lower for international than for North American PICUs, except for Germany and Japan, which were slightly higher.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Lee JH, Nuthall G, Ikeyama T .
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Pediatr Crit Care Med 2019 Jan;20(1):1-8. doi: 10.1097/pcc.0000000000001782..
Keywords: Adverse Events, Care Management, Children/Adolescents, Intensive Care Unit (ICU), Respiratory Conditions, Outcomes, Patient Safety
Karandikar MV, Coffin SE, Priebe GP
Variability in antimicrobial use in pediatric ventilator-associated events.
This article describes a study which assesses variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs). 192 patients with ventilator-associated conditions were identified in neonatal, pediatric, and cardiac ICUs in six hospitals. Type and duration of antimicrobial use varied by ICU type. The authors conclude that antimicrobial use is common in pediatric ventilator-associated conditions, but pediatric VAP is uncommon; prolonged usage of antimicrobials in spite of low pediatric VAP rates or positive laboratory testing for infection suggests that pediatric ventilator-associated conditions with antimicrobial use for >/= 4 days may provide a lever for antimicrobial stewardship programs to improve utilization.
AHRQ-funded; HS021636.
Citation: Karandikar MV, Coffin SE, Priebe GP .
Variability in antimicrobial use in pediatric ventilator-associated events.
Infect Control Hosp Epidemiol 2019 Jan;40(1):32-39. doi: 10.1017/ice.2018.264..
Keywords: Adverse Events, Antimicrobial Stewardship, Children/Adolescents, Healthcare-Associated Infections (HAIs), Respiratory Conditions
Panupattanapong S, Stwalley DL, White AJ
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
This retrospective cohort study examined the epidemiology and outcomes of granulomatosis with polyangiitis (GPA) in pediatric and working-age adult populations in the US. The study used data from the 2006-2014 Truven Health Analytics MarketScan Commercial Claims and Encounters Database. The incidence is rare in children, with a total of 214 (3.8%) out of 5,562 cases identified as pediatric onset. The incidence rate in children was 1.8 cases per 1 million person-years as opposed to 12.8 cases per 1 million person-years in working age adults. Children were more like to have frequent hospitalizations and severe infections including leukopenia, neutropenia, and hypogammaglobulinemia than the non-elderly adults.
AHRQ-funded; HS019455.
Citation: Panupattanapong S, Stwalley DL, White AJ .
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
Arthritis Rheumatol 2018 Dec;70(12):2067-76. doi: 10.1002/art.40577..
Keywords: Children/Adolescents, Hospitalization, Respiratory Conditions, Cardiovascular Conditions