National Healthcare Quality and Disparities Report
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- Adverse Events (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 8 of 8 Research Studies DisplayedMetersky ML, Wang Y, Klompas M
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
The purpose of this retrospective cohort study was to assess change in rates of postoperative pneumonia and ventilator-associated pneumonia among patients hospitalized in the United States during 2009-2019. The study found that among 58,618 patients undergoing major surgical procedures between 2009 and 2019, the observed rate of postoperative pneumonia from 2009-2011 was 1.9% and decreased to 1.3% during 2017-2019. The adjusted annual risk each year, compared to the prior year, was 0.94. Among 4,007 patients hospitalized for any of the 4 conditions at risk for ventilator-associated pneumonia during 2009-2019, the researchers did not detect a significant change in observed or adjusted rates. Observed rates clustered around 10%, and adjusted annual risk compared to the prior year was 0.99.
AHRQ-funded; 290201800005C.
Citation: Metersky ML, Wang Y, Klompas M .
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
Infect Control Hosp Epidemiol 2023 Aug; 44(8):1247-54. doi: 10.1017/ice.2022.264..
Keywords: Pneumonia, Respiratory Conditions, Healthcare-Associated Infections (HAIs), Healthcare Cost and Utilization Project (HCUP)
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Feemster K, Localio R, Grundmeier R
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
The authors evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI) using electronic health record data. They found that pediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged less than 2 years. They concluded that their findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in healthcare-associated ILI in young children.
AHRQ-funded; HS020939.
Citation: Feemster K, Localio R, Grundmeier R .
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
J Pediatric Infect Dis Soc 2019 Jul 1;8(3):191-96. doi: 10.1093/jpids/piy023..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Infectious Diseases, Influenza, Primary Care, Healthcare Delivery, Ambulatory Care and Surgery, Respiratory Conditions
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
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Metersky ML, Klompas M, Eldridge N
Changes in rates of ventilator-associated pneumonia-reply.
In response to a critical letter, the authors comment that the discordance between ventilator-associated pneumonia (VAP) rates from the Medicare Patient Safety Monitoring System (MPSMS) vs the National Healthcare Safety Network (NHSN)is likely related to differences in data sources, as discussed in their report, including conscious or unconscious bias in VAP rates reported to the NHSN. It is unlikely to be related to differences in denominators or competing risks.
AHRQ-authored.
Citation: Metersky ML, Klompas M, Eldridge N .
Changes in rates of ventilator-associated pneumonia-reply.
JAMA 2017 Apr 18;317(15):1581-82. doi: 10.1001/jama.2017.2431.
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Keywords: Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient Safety, Respiratory Conditions
Muray MT, Jackson O, Cohen B
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Researchers evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly.
AHRQ-funded; HS021470.
Citation: Muray MT, Jackson O, Cohen B .
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Infect Control Hosp Epidemiol 2016 Jul;37(7):859-62. doi: 10.1017/ice.2016.73.
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Keywords: Healthcare-Associated Infections (HAIs), Children/Adolescents, Long-Term Care, Prevention, Respiratory Conditions