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- Access to Care (1)
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- Sepsis (3)
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- Transitions of Care (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 13 of 13 Research Studies DisplayedNewgard CD, Lin A, Caughey AB
Falls in older adults requiring emergency services: mortality, use of healthcare resources, and prognostication to one year.
The purpose of this study was to assess the prognoses, healthcare use, transitions to skilled nursing or hospice, and mortality of older, community-living adults after a fall. The researchers conducted a secondary analysis of all adults in 7 Northwest U.S. counties greater than or equal to 65 years of age who had been transported to one of 51 hospitals after a fall. The study analyzed Medicare claims, state trauma registry data, state inpatient data, and death records for outcomes which included healthcare use, new claims for skilled nursing and hospice for one year, and mortality. The researchers found that in 3,159 older adults there were 147 deaths within 30 days and 665 deaths within one year, and the following predictors of mortality: respiratory diagnosis, serious brain injury, having a baseline disability, or a score of greater than or equal to 2 on the Charlson Comorbidity Index. The study concluded that in the year after experiencing a fall, community-living older adults who require ambulance transport to the hospital have increases in institutionalized living, the utilization of health care, and mortality.
AHRQ-funded; HS023796.
Citation: Newgard CD, Lin A, Caughey AB .
Falls in older adults requiring emergency services: mortality, use of healthcare resources, and prognostication to one year.
West J Emerg Med 2022 May 14;23(3):375-85. doi: 10.5811/westjem.2021.11.54327..
Keywords: Elderly, Falls, Emergency Department, Mortality, Healthcare Utilization
Greenwood-Ericksen M, Kamdar N, Lin P
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
This study compared 30-day mortality rates after emergency department (ED) visits to rural or critical access hospitals (CAHs) compared to urban hospitals for Medicare beneficiaries. A 20% sample of Medicare beneficiaries was used from January 2011 to October 31, 2015. The primary outcome measured was 30-day mortality. Secondary outcome examined was ED visits with and without rehospitalization. Mortality rates were comparable with both groups, although patients in rural EDs experienced more transfers and less hospitalization.
AHRQ-funded; HS024160.
Citation: Greenwood-Ericksen M, Kamdar N, Lin P .
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
JAMA Netw Open 2021 Nov;4(11):e2134980. doi: 10.1001/jamanetworkopen.2021.34980..
Keywords: Hospitals, Rural Health, Urban Health, Emergency Department, Mortality, Outcomes
Slatnick LR, Thornhill D, Deakyne Davies
Disseminated intravascular coagulation is an independent predictor of adverse outcomes in children in the emergency department with suspected sepsis.
The purpose of this study was to evaluate the impact of early disseminated intravascular coagulation (DIC) on illness severity in children using a database of emergency department ED encounters for children with suspected sepsis, in view of similar associations in adults. The investigators concluded that a DIC score of ≥3 was an independent predictor for both vasopressor use and mortality in this pediatric cohort, distinct from the adult overt DIC score cutoff of ≥5.
AHRQ-funded; HS025696.
Citation: Slatnick LR, Thornhill D, Deakyne Davies .
Disseminated intravascular coagulation is an independent predictor of adverse outcomes in children in the emergency department with suspected sepsis.
J Pediatr 2020 Oct;225:198-206.e2. doi: 10.1016/j.jpeds.2020.06.022..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Adverse Events, Mortality, Patient Safety, Outcomes
Arulraja MD, Swanson MB, NM
Double inter-hospital transfer in sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.
This study investigated whether double inter-hospital transfer in sepsis patients presenting to the emergency department (ED) worsens mortality compared to single inter-hospital transfer. A retrospective cohort study was conducted using 2005-2014 administrative claims data in Iowa. Hospital length-of-stay and cost data was also collected. Compared to non-transfers, single transfers did not have higher mortality rates than double transfers of Iowa sepsis patients.
AHRQ-funded; HS025753.
Citation: Arulraja MD, Swanson MB, NM .
Double inter-hospital transfer in sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.
J Crit Care 2020 Apr;56:49-57. doi: 10.1016/j.jcrc.2019.11.018..
Keywords: Sepsis, Transitions of Care, Mortality, Hospitals, Emergency Department, Outcomes
Woodworth L
Swamped: emergency department crowding and patient mortality.
U.S. emergency departments are experiencing extreme levels of crowding. This study estimated the impact of emergency department crowding on patient mortality. Identification relied on the abrupt crowding shocks felt by "old" emergency departments at the time a new emergency department opened nearby. Using death records linked to hospital administrative records, the investigator found that a 10% alleviation of emergency department patient volume significantly lowered the average patient's chance of mortality.
AHRQ-funded; HS022236.
Citation: Woodworth L .
Swamped: emergency department crowding and patient mortality.
J Health Econ 2020 Mar;70:102279. doi: 10.1016/j.jhealeco.2019.102279..
Keywords: Emergency Department, Mortality, Patient-Centered Outcomes Research
Lauerman MH, Herrera AV, Albrecht JS
Percentage of mortal encounters transferred in emergency general surgery.
The purpose of this study was to describe individual hospital transfer rates of mortal encounters. Using data from the Maryland Health Services Cost Review Commission database, results showed broad variability in individual hospital practices for mortality transferred to other institutions. Application of this knowledge of percentage of mortal encounters transferred includes consideration in hospital quality metrics.
AHRQ-funded; HS024560.
Citation: Lauerman MH, Herrera AV, Albrecht JS .
Percentage of mortal encounters transferred in emergency general surgery.
J Surg Res 2019 Nov;243:391-98. doi: 10.1016/j.jss.2019.05.040.
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Keywords: Emergency Department, Surgery, Mortality, Hospitals
Daniel VT, Rushing AP, Ingraham AM
Association between operating room access and mortality for life-threatening general surgery emergencies.
Few diseases truly require emergency surgery today. In this study, the authors investigated the relationship between access to operating room (OR) and outcomes for patients with life-threatening emergency general surgery (LT-EGS) diseases at US hospitals. The investigators concluded that round-the-clock availability of personnel, specifically emergency general surgeons and recovery room nurses, is associated with decreased mortality.
AHRQ-funded; HS022694.
Citation: Daniel VT, Rushing AP, Ingraham AM .
Association between operating room access and mortality for life-threatening general surgery emergencies.
J Trauma Acute Care Surg 2019 Jul;87(1):35-42. doi: 10.1097/ta.0000000000002267..
Keywords: Access to Care, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Surgery
Meagher AD, Lin A, Mandell SP
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Researchers conducted a retrospective cohort study to identify injured older adults at highest risk for 30-day mortality. They found that older, injured adults transported by EMS to a large variety of trauma and non-trauma hospitals were more likely to die within 30 days if they required emergent airway management or had a higher comorbidity burden. They concluded that identification of an ideal prognostic tool remains elusive.
AHRQ-funded; HS023796.
Citation: Meagher AD, Lin A, Mandell SP .
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Acad Emerg Med 2019 Jun;26(6):621-30. doi: 10.1111/acem.13727..
Keywords: Elderly, Trauma, Mortality, Injuries and Wounds, Emergency Department
Austrian JS, Jamin CT, Doty GR
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
The goal of this study was to determine if an electronic health record (EHR) based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. A patient-level, interrupted time series study of emergency department patients with severe sepsis or septic shock was conducted, with an intervention introduced at the approximate mid-point--a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Mean length of stay for patients with sepsis decreased significantly following the introduction of the alert, but the alert system had no effect on mortality or other clinical or process measures. The researchers conclude that a more sophisticated algorithm for sepsis identification is needed to improve outcomes.
AHRQ-funded; HS023683.
Citation: Austrian JS, Jamin CT, Doty GR .
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
J Am Med Inform Assoc 2018 May;25(5):523-29. doi: 10.1093/jamia/ocx072..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Mortality, Outcomes, Quality Improvement, Quality of Care, Sepsis
de Cordova PB, Johansen ML, Martinez ME
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
The purpose of this research was to determine if weekend and holiday presentation is associated with increased mortality in EDs among patients with acute myocardial infarction (AMI) in New Jersey. It found that weekend/holiday presentation to the ED for AMI was associated with increased mortality. The effect may be related to the limited availability of resources on weekend/holidays compared to weekdays.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Martinez ME .
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
Nurs Res 2017 Jan/Feb;66(1):20-27. doi: 10.1097/nnr.0000000000000196.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Mortality, Heart Disease and Health, Risk
Vogel JA, Seleno N, Hopkins E
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. It concluded that The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the other three.
AHRQ-funded; HS017526.
Citation: Vogel JA, Seleno N, Hopkins E .
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
Am J Emerg Med 2015 Oct;33(10):1440-4. doi: 10.1016/j.ajem.2015.07.006..
Keywords: Emergency Medical Services (EMS), Risk, Mortality, Comparative Effectiveness, Emergency Department
Vickers BP, Shi J, Lu B
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
The researchers used National Emergency Department Sample (NEDS) data to explore the hypothesis that severely injured trauma victims properly triaged to a level I or level II trauma center have significantly lower odds of death than those undertriaged to a non-trauma center. They found that trauma patients with Injury Severity Score of greater than 25 received most benefit from proper triage. Efforts to reduce undertriage should focus on this population.
AHRQ-funded; HS022277.
Citation: Vickers BP, Shi J, Lu B .
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
Am J Emerg Med 2015 Sep;33(9):1158-65. doi: 10.1016/j.ajem.2015.05.010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Trauma, Comparative Effectiveness, Mortality
Peng J, Wheeler K, Shi J
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Its results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified.
AHRQ-funded; HS022277.
Citation: Peng J, Wheeler K, Shi J .
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
PLoS One 2015 Jul 31;10(7):e0134821. doi: 10.1371/journal.pone.0134821..
Keywords: Mortality, Healthcare Cost and Utilization Project (HCUP), Trauma, Emergency Medical Services (EMS), Emergency Department