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- Children/Adolescents (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedBergman ZR, Tignanelli CJ, Gould R
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
This study examined outcomes for COVID-19 patients who required mechanical ventilation from March 2020 through December 2021 across a system of 11 hospitals. A cohort of 600 patients were included, with in-hospital mortality of 40.3%. Increased age, prolonged ventilation, receiving corticosteroids, and being non-English speaking were associated with mortality. Intubations lasting longer than 21 days had a lower in-hospital mortality of 25.7%.
AHRQ-funded; HS026379.
Citation: Bergman ZR, Tignanelli CJ, Gould R .
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
Surg Infect 2022 Dec;23(10):893-901. doi: 10.1089/sur.2022.195..
Keywords: COVID-19, Mortality, Respiratory Conditions
Lindell RB, Fitzgerald JC, Rowan CM
The use and duration of preintubation respiratory support is associated with increased mortality in immunocompromised children with acute respiratory failure.
The purpose of this retrospective cohort study was to examine the relationship between preintubation respiratory support and outcomes in pediatric patients with acute respiratory failure and to evaluate the impact of immunocompromised (IC) diagnoses on outcomes. The study utilized data from the Virtual Pediatric Systems database which included 82 centers, and focused on patients intubated in the Pediatric Intensive Care Unit (PICU) ranging in age from 1 month old to 17 years of age who received invasive mechanical ventilation (IMV) for more than or equal to 24 hours. Of the 5,348 PICU intubations across 82 centers, high-flow nasal cannula (HFNC) or noninvasive positive-pressure ventilation (NIPPV) or both were used before intubation in 34% (1,825) of patients. Fifty percent of the patients had no IC diagnosis. The researchers found that exposure to HFNC was associated with greater odds of PICU mortality when compared with patients intubated without prior support. When analyzing subgroups of IC status, preintubation support was related to higher odds of PICU mortality in IC patients and HCT patients when compared with IC/ HCT patients intubated without prior respiratory support. A duration of HFNC/NIPPV of more than 6 hours was associated with increased mortality in IC HCT patients. Rates of preintubation HFNC/NIPPV use and PICU mortality varied between the 82 centers. The researchers concluded that greater duration of exposure to HFNC/NIPPV prior to IMV is associated with increased mortality in HCT patients, and preintubation exposure to HFNC and/or NIPPV in IC pediatric patients is associated with increased odds of PICU mortality, independent of the severity of the illness.
AHRQ-funded; HS024511.
Citation: Lindell RB, Fitzgerald JC, Rowan CM .
The use and duration of preintubation respiratory support is associated with increased mortality in immunocompromised children with acute respiratory failure.
Crit Care Med 2022 Jul;50(7):1127-37. doi: 10.1097/ccm.0000000000005535..
Keywords: Children/Adolescents, Respiratory Conditions, Mortality, Critical Care
Stevens JP, Dechen T, Schwartzstein RM
Association of dyspnoea, mortality and resource use in hospitalised patients.
As many as one in 10 patients experience dyspnoea at hospital admission but the relationship between dyspnoea and patient outcomes is unknown. In this study, the investigators sought to determine whether dyspnoea on admission predicts outcomes. They conducted a retrospective cohort study in a single, academic medical centre. They analysed 67 362 consecutive hospital admissions with available data on dyspnoea, pain and outcomes.
AHRQ-funded; HS024288.
Citation: Stevens JP, Dechen T, Schwartzstein RM .
Association of dyspnoea, mortality and resource use in hospitalised patients.
Eur Respir J 2021 Sep 2;58(3). doi: 10.1183/13993003.02107-2019..
Keywords: Respiratory Conditions, Mortality, Outcomes
Gershengorn HB, Hu Y, Chen JT
The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19.
This study looked at the effects of the use of high-flow nasal cannula for COVID-19 patients on mortality and the availability of mechanical ventilators. The authors constructed dynamical simulation models of high-flow nasal cannula and mechanical ventilation use in the United States. There were two outcomes looked for: 1) cumulative number of deaths; and 2) days without available ventilators. The strategy resulted in an estimated number of 10,000-40,000 fewer deaths than if high-flow nasal cannula were not available. This strategy also led up to 25 fewer days without available ventilators.
AHRQ-funded; HS026188.
Citation: Gershengorn HB, Hu Y, Chen JT .
The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19.
Ann Am Thorac Soc 2021 Apr;18(4):623-31. doi: 10.1513/AnnalsATS.202007-803OC..
Keywords: COVID-19, Respiratory Conditions, Mortality, Critical Care
Pennington KM, Dykhoff HJ, Yao X
The impact of antifungal prophylaxis in lung transplant recipients.
This study evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) on lung transplant recipients. Administrative claims data was used to identify adult patients who underwent lung transplantation between 2005 and 2018. The authors identified 662 lung transplant recipients. All-cause mortality was found to be significantly lower in those receiving antifungal prophylaxis compared to those who did not. Patients receiving antifungal prophylaxis also had a lower rate of IFI, but it was not statistically significant.
AHRQ-funded; HS025164; HS025402; HS025517; HS024075.
Citation: Pennington KM, Dykhoff HJ, Yao X .
The impact of antifungal prophylaxis in lung transplant recipients.
Ann Am Thorac Soc 2021 Mar;18(3):468-76. doi: 10.1513/AnnalsATS.202003-267OC..
Keywords: Transplantation, Surgery, Medication, Prevention, Respiratory Conditions, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Puebla Neira DA, Hsu ES, Kuo YF
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Implementation of the Hospital Readmissions Reduction Program (HRRP) following discharge of patients with chronic obstructive pulmonary disease (COPD) has led to a reduction in 30-day readmissions with unknown effects on postdischarge mortality. The objective of this retrospective cohort study was to examine the association of HRRP with 30-day hospital readmission and 30-day postdischarge mortality rate in patients after discharge from COPD hospitalization.
AHRQ-funded; HS020642.
Citation: Puebla Neira DA, Hsu ES, Kuo YF .
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Am J Respir Crit Care Med 2021 Feb 15;203(4):437-46. doi: 10.1164/rccm.202002-0310OC..
Keywords: Hospital Readmissions, Respiratory Conditions, Chronic Conditions, Mortality, Hospital Discharge, Hospitalization
Donnelly JP, Wang XQ, Iwashyna TJ
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
This study describes reasons for readmission, use of intensive care unit (ICU) interventions during readmission, and proportions of death after initial hospital discharge of COVID-19 patients from US Veterans Affairs (VA) hospitals March-June 2020.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Wang XQ, Iwashyna TJ .
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
JAMA 2021 Jan 19;325(3):304-06. doi: 10.1001/jama.2020.21465.
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Keywords: Respiratory Conditions, COVID-19, Hospital Readmissions, Hospital Discharge, Mortality, Outcomes
Goto T, Hirayama A, Faridi MK
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
A study was done to determine if there was an increase in severity and mortality with chronic obstructive pulmonary disease (COPD) patients who were also obese. Researchers used data from 2012-2013 State Inpatient Databases data of seven U.S. states. 17% of COPD patients in the database were defined as obese. Obesity was shown to increase use of ventilation, increased hospital stays but not in-hospital mortality.
AHRQ-funded; HS023305.
Citation: Goto T, Hirayama A, Faridi MK .
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2018 Feb;15(2):184-91. doi: 10.1513/AnnalsATS.201706-485OC..
Keywords: Chronic Conditions, Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Obesity
Travers CP, Carlo WA, McDonald SA
Mortality and pulmonary outcomes of extremely preterm infants exposed to antenatal corticosteroids.
This study sought to determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age. It concluded that among infants 22-28 weeks' gestational age, any or partial antenatal exposure to corticosteroids compared to no exposure is associated with a lower rate of death while the rate of bronchopulmonary dysplasia in survivors did not differ.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA, McDonald SA .
Mortality and pulmonary outcomes of extremely preterm infants exposed to antenatal corticosteroids.
Am J Obstet Gynecol 2018 Jan;218(1):130.e1-30.e13. doi: 10.1016/j.ajog.2017.11.554.
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Keywords: Medication, Mortality, Newborns/Infants, Patient-Centered Outcomes Research, Respiratory Conditions
Jolley SE, Hough CL, Clermont G
Relationship between race and the effect of fluids on long-term mortality after acute respiratory distress syndrome. secondary analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial.
Short-term follow-up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction. A post hoc analysis of FACTT and the Economic Analysis of Pulmonary Artery Catheters (EAPAC) study was performed. The researchers found that in their cohort, conservative fluid management may have improved 1-year mortality for non-Hispanic black patients with ARDS. However, they found no long-term benefit of conservative fluid management in white subjects.
AHRQ-funded; HS011620.
Citation: Jolley SE, Hough CL, Clermont G .
Relationship between race and the effect of fluids on long-term mortality after acute respiratory distress syndrome. secondary analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial.
Ann Am Thorac Soc 2017 Sep;14(9):1443-49. doi: 10.1513/AnnalsATS.201611-906OC..
Keywords: Racial and Ethnic Minorities, Respiratory Conditions, Mortality
Sloan CD, Gebretsadik T, Rosas-Salazar C
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
The researchers analyzed ecological associations between timing of Sudden Unexplained Infant Death (SUID) cases, bronchiolitis, and apnea healthcare visits. They found a temporal relationship between infant bronchiolitis and apnea, but no peak in SUID cases during peaks of bronchiolitis. They concluded that consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases.
AHRQ-funded; HS018454.
Citation: Sloan CD, Gebretsadik T, Rosas-Salazar C .
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
PLoS One 2016 Jul 12;11(7):e0158521. doi: 10.1371/journal.pone.0158521.
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Keywords: Newborns/Infants, Respiratory Conditions, Mortality
Walkey AJ, Weinberg J, Wiener RS
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
The researchers evaluated the effect of analytic approaches accounting for do-not-resuscitate (DNR) status on risk-adjusted hospital mortality rates and performance rankings. They found that after accounting for patient DNR status and between-hospital variation in the association between DNR status and mortality, hospitals with higher DNR rates had lower mortality.
AHRQ-funded; HS020672.
Citation: Walkey AJ, Weinberg J, Wiener RS .
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
JAMA Intern Med 2016 Jan;176(1):97-104. doi: 10.1001/jamainternmed.2015.6324.
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Keywords: Hospitals, Mortality, Quality of Care, Quality Indicators (QIs), Quality Measures, Pneumonia, Provider Performance, Respiratory Conditions