National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (4)
- Community-Acquired Infections (3)
- Diagnostic Safety and Quality (2)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Healthcare-Associated Infections (HAIs) (2)
- Health Information Technology (HIT) (2)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (4)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Labor and Delivery (1)
- Medical Errors (1)
- Medication (4)
- Mortality (2)
- Newborns/Infants (1)
- Nursing (1)
- Racial and Ethnic Minorities (2)
- (-) Risk (16)
- (-) Sepsis (16)
- Stroke (2)
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 16 of 16 Research Studies DisplayedFlannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
AHRQ-funded; HS027468.
Citation: Flannery DD, Mukhopadhyay S, Morales KH .
Delivery characteristics and the risk of early-onset neonatal sepsis.
Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Garcia MA, Rucci JM, Thai KK
Association between troponin I levels during sepsis and postsepsis cardiovascular complications.
This study examined whether there is an association between elevated serum troponin levels and increased risk for postsepsis cardiovascular complications in patients who had been admitted for sepsis without preexisting cardiovascular disease within 5 years in adults 40 years and older. The patients were admitted with sepsis across 21 hospitals from 2011 to 2017. Peak serum troponin I levels during sepsis were grouped as normal, or tertiles of abnormal from a low of 0.04 to 0.43 ng/ml. Among 14,046 eligible adults, 10.9% had normal troponin levels, as compared to 17.3% at tertile 1, 17.6% at tertile 2, and 20.3% at tertile 3. Patients within the elevated troponin tertiles had increased risks of adverse cardiovascular events.
AHRQ-funded; HS026485.
Citation: Garcia MA, Rucci JM, Thai KK .
Association between troponin I levels during sepsis and postsepsis cardiovascular complications.
Am J Respir Crit Care Med 2021 Sep 1;204(5):557-65. doi: 10.1164/rccm.202103-0613OC..
Keywords: Sepsis, Cardiovascular Conditions, Risk
Cifra CL, Westlund E, Ten Eyck P
An estimate of missed pediatric sepsis in the emergency department.
AHRQ-funded; HS025753.
Citation: Cifra CL, Westlund E, Ten Eyck P .
An estimate of missed pediatric sepsis in the emergency department.
Diagnosis 2021;8(2):193-98. doi: 10.1515/dx-2020-0023..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Risk
Kadri SS, Lai YL, Warner S
Inappropriate empirical antibiotic therapy for bloodstream infections based on discordant in-vitro susceptibilities: a retrospective cohort analysis of prevalence, predictors, and mortality risk in US hospitals.
Researchers sought to establish the population-level burden, predictors, and mortality risk of in-vitro susceptibility-discordant empirical antibiotic therapy among patients with bloodstream infections. They found that approximately one in five patients with bloodstream infections in US hospitals received discordant empirical antibiotic therapy, receipt of which was closely associated with infection with antibiotic-resistant pathogens. Receiving discordant empirical antibiotic therapy was associated with increased odds of mortality overall, even in patients without sepsis. They concluded that early identification of bloodstream pathogens and resistance will probably improve population-level outcomes.
AHRQ-funded.
Citation: Kadri SS, Lai YL, Warner S .
Inappropriate empirical antibiotic therapy for bloodstream infections based on discordant in-vitro susceptibilities: a retrospective cohort analysis of prevalence, predictors, and mortality risk in US hospitals.
Lancet Infect Dis 2021 Feb;21(2):241-51. doi: 10.1016/s1473-3099(20)30477-1..
Keywords: Antibiotics, Medication, Sepsis, Antimicrobial Stewardship, Mortality, Risk
Rinke ML, Heo M, Saiman L
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
AHRQ-funded; HS024432.
Citation: Rinke ML, Heo M, Saiman L .
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Ambulatory Care and Surgery, Risk, Sepsis
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
Scott HF, Colborn KL, Sevick CJ
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
The purpose of this observational cohort study was to derive and validate a model of risk of septic shock among children with suspected sepsis, using data known in the electronic health record at hospital arrival. The investigators concluded that their model estimated the risk of septic shock in children at hospital arrival earlier than existing models. They indicate it leveraged the predictive value of routine electronic health record data through a modern predictive algorithm and suggest it has the potential to enhance clinical risk stratification in the critical moments before deterioration.
AHRQ-funded; HS025696.
Citation: Scott HF, Colborn KL, Sevick CJ .
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
J Pediatr 2020 Feb;217:145-51.e6. doi: 10.1016/j.jpeds.2019.09.079..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Hospitals, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Delahanty RJ, Alvarez J, Flynn LM
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
In this study, the investigators aimed to use machine learning to develop a new sepsis screening tool, the Risk of Sepsis (RoS) score, and compare it with a slate of benchmark sepsis-screening tools, including the Systemic Inflammatory Response Syndrome, Sequential Organ Failure Assessment (SOFA), qSOFA, Modified Early Warning Score, and National Early Warning Score. The investigators concluded that in this retrospective study, RoS was more timely and discriminant than benchmark screening tools, including those recommend by the Sepsis-3 Task Force.
AHRQ-funded; HS024750.
Citation: Delahanty RJ, Alvarez J, Flynn LM .
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
Ann Emerg Med 2019 Apr;73(4):334-44. doi: 10.1016/j.annemergmed.2018.11.036..
Keywords: Health Information Technology (HIT), Hospitals, Risk, Sepsis
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Chaudhary NS, Donnelly JP, Moore JX
Association of baseline steroid use with long-term rates of infection and sepsis in the REGARDS cohort.
Prior studies associate steroid use with infection risk but were limited to select populations and short follow-up periods. This population-based cohort study sought to determine the association of steroid risk with long-term risks of community- acquired infections and sepsis. It concluded that baseline steroid use was associated with increased long-term risks of community-acquired infections and sepsis.
AHRQ-funded; HS013852.
Citation: Chaudhary NS, Donnelly JP, Moore JX .
Association of baseline steroid use with long-term rates of infection and sepsis in the REGARDS cohort.
Crit Care 2017 Jul 13;21(1):185. doi: 10.1186/s13054-017-1767-1.
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Keywords: Healthcare-Associated Infections (HAIs), Medication, Sepsis, Risk
Bhattacharjee P, Churpek MM, Snyder A
Detecting sepsis: are two opinions better than one?
Researchers conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. They concluded that provider disagreement regarding suspected infection is common, with RNs suspecting infection more often, suggesting that a collaborative model for sepsis detection may improve timing and accuracy.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Churpek MM, Snyder A .
Detecting sepsis: are two opinions better than one?
J Hosp Med 2017 Apr;12(4):256-58. doi: 10.12788/jhm.2721.
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Keywords: Diagnostic Safety and Quality, Nursing, Risk, Sepsis
Wang HE, Donnelly JP, Griffin R
Derivation of novel risk prediction scores for community-acquired sepsis and severe sepsis.
The researchers derived and internally validated a Sepsis Risk Score and a Severe Sepsis Risk Score predicting future sepsis and severe sepsis events among community-dwelling adults. They concluded that the Sepsis Risk Score and Severe Sepsis Risk Score predict 10-year sepsis and severe sepsis risk among community-dwelling adults and may aid in sepsis prevention or mitigation efforts.
AHRQ-funded; HS013852.
Citation: Wang HE, Donnelly JP, Griffin R .
Derivation of novel risk prediction scores for community-acquired sepsis and severe sepsis.
Crit Care Med 2016 Jul;44(7):1285-94. doi: 10.1097/ccm.0000000000001666.
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Keywords: Community-Acquired Infections, Risk, Risk, Sepsis
Donnelly JP, Hohmann SF, Wang HE
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
The researchers sought to characterize 7- and 30-day readmission rates following hospital admission for severe sepsis as well as institutional variations in readmission. They concluded that severe sepsis readmission places a substantial burden on the healthcare system, with one in 15 and one in five severe sepsis discharges readmitted within 7 and 30 days, respectively.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Hohmann SF, Wang HE .
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
Crit Care Med 2015 Sep;43(9):1916-27. doi: 10.1097/ccm.0000000000001147..
Keywords: Hospital Readmissions, Hospitals, Risk, Sepsis
Kane-Gill SL, Sileanu FE, Murugan R
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
The authors sought to delineate the determinants of risk for acute kidney injury (AKI) in older compared with younger adults. They found that among the risk factors for AKI in the oldest age category were drugs (vancomycin, aminoglycosides, and nonsteroidal anti-inflammatories), history of hypertension, and sepsis. Fewer variables remained predictive of AKI as age increased and the model for older patients was less predictive.
AHRQ-funded; HS018721.
Citation: Kane-Gill SL, Sileanu FE, Murugan R .
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
Am J Kidney Dis 2015 Jun;65(6):860-9. doi: 10.1053/j.ajkd.2014.10.018.
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Keywords: Elderly, Kidney Disease and Health, Medication, Risk, Sepsis
Powell TC, Donnelly JP, Gutierrez OM
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
The researchers sought to determine the association between elevated baseline Cyst-C and long-term rates of community-acquired sepsis. They found that elevated Cyst-C is associated with increased long-term rates of community-acquired sepsis, independent of abnormal eGFR, ACR or hsCRP. Cyst-C may play a role in long-term sepsis risk prediction and prevention.
AHRQ-funded; HS013852.
Citation: Powell TC, Donnelly JP, Gutierrez OM .
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
BMC Nephrol 2015 Apr 23;16:61. doi: 10.1186/s12882-015-0055-z..
Keywords: Community-Acquired Infections, Kidney Disease and Health, Risk, Sepsis