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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 17 of 17 Research Studies DisplayedAnderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
Newgard 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
Huo J, Lairson DR, Du XL
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
This study investigated the influence of hospital case volume on malignant melanoma survival and treatment utilization. The researchers discovered that for patients diagnosed with metastatic melanoma, being treated in a high-volume hospital was associated with an improvement in survival and lower utilization of chemotherapy, immunotherapy, surgery, and radiation therapy.
AHRQ-funded; HS018956.
Citation: Huo J, Lairson DR, Du XL .
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
Am J Clin Oncol 2016 Oct;39(5):491-6. doi: 10.1097/coc.0000000000000074.
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Keywords: Elderly, Hospitals, Mortality, Patient-Centered Outcomes Research, Cancer: Skin Cancer
Albrecht JS, McCunn M, Stein DM
Sex differences in mortality following isolated traumatic brain injury among older adults.
This retrospective cohort study's objective was to determine the possibility of sex differences in mortality among older adutls following isolated traumatic brain injury (TBI) and to comapre with findings using all TBI. The researchers did not find that women were significantly associated with decreased odds of mortality following isolated TBI.
AHRQ-funded; HS024560.
Citation: Albrecht JS, McCunn M, Stein DM .
Sex differences in mortality following isolated traumatic brain injury among older adults.
J Trauma Acute Care Surg 2016 Sep;81(3):486-92. doi: 10.1097/ta.0000000000001118.
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Keywords: Sex Factors, Trauma, Brain Injury, Mortality, Elderly
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Laccetti AL, Pruitt SL, Xuan L
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Researchers identified patients > 65 years of age diagnosed 1992-2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. They found that, for patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Pruitt SL, Xuan L .
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Lung Cancer 2016 Aug;98:106-13. doi: 10.1016/j.lungcan.2016.05.029.
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Keywords: Elderly, Cancer: Lung Cancer, Medicare, Mortality, Patient-Centered Outcomes Research
Mehta HB, Parmar AD, Adhikari D
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
This study's objective was to evaluate the relative effects of surgeon and hospital volume on mortality and complications after pancreatic resection among older patients. The researchers used Texas Medicare data and found that high surgeon volume and high hospital volume were associated with lower risk of mortality, while high surgeon volume was also associated with lower risk of complications.
AHRQ-funded; HS022134.
Citation: Mehta HB, Parmar AD, Adhikari D .
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
J Surg Res 2016 Aug;204(2):326-34. doi: 10.1016/j.jss.2016.05.008.
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Keywords: Adverse Events, Elderly, Hospitals, Mortality, Surgery
Fernandez FG, Furnary AP, Kosinski AS
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
The purpose of this paper was to provide longitudinal follow-up to the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) through linkage to the Centers for Medicare and Medicaid Services (CMS) data for patients 65 years of age or older. The researchers found that median survival after lung cancer resection was 6.7 years for pathologic stage I, 3.5 years for stage II, 2.4 years for stage III, and 2.2 years for stage IV. They concluded that CMS data complement the STS GTSD data by enabling examination of long-term survival and resource utilization in patients 65 years or older.
AHRQ-funded; HS022279.
Citation: Fernandez FG, Furnary AP, Kosinski AS .
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
Ann Thorac Surg 2016 Jun;101(6):2067-76. doi: 10.1016/j.athoracsur.2016.03.034.
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Keywords: Cancer: Lung Cancer, Surgery, Elderly, Outcomes, Mortality
Lee T, Thamer M, Zhang Q
Reduced cardiovascular mortality associated with early vascular access placement in elderly patients with chronic kidney disease.
This study assessed whether there has been a decrease in cardiovascular comorbidity in elderly chronic kidney disease (CKD) patients undergoing predialysis access surgery, and whether this impacted clinical outcomes after access creation and cardiovascular events after hemodialysis initiation. It concluded that a progressive decrease in cardiovascular comorbidities in elderly CKD patients undergoing predialysis vascular access surgery was associated with a decrease in death before hemodialysis and cardiovascular events after starting hemodialysis.
AHRQ-funded; HS022931.
Citation: Lee T, Thamer M, Zhang Q .
Reduced cardiovascular mortality associated with early vascular access placement in elderly patients with chronic kidney disease.
Am J Nephrol 2016;43(5):334-40. doi: 10.1159/000446159.
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Keywords: Cardiovascular Conditions, Elderly, Kidney Disease and Health, Kidney Disease and Health, Mortality
Sheetz KH, Dimick JB, Ghaferi AA
Impact of hospital characteristics on failure to rescue following major surgery.
This study determined the effect of hospital characteristics on failure to rescue after high-risk surgery in Medicare beneficiaries. It found that although several hospital characteristics are associated with lower failure to rescue rates, these macrosystem factors explain a small proportion of the variability between hospitals. This suggests that microsystem characteristics may play a larger role in improving a hospital's ability to manage postoperative complications.
AHRQ-funded; HS023621.
Citation: Sheetz KH, Dimick JB, Ghaferi AA .
Impact of hospital characteristics on failure to rescue following major surgery.
Ann Surg 2016 Apr;263(4):692-7. doi: 10.1097/sla.0000000000001414.
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Keywords: Surgery, Elderly, Adverse Events, Disparities, Mortality
Banerjee M, Lao CD, Wancata LM
Implications of age and conditional survival estimates for patients with melanoma.
This study identified newly diagnosed cutaneous melanoma patients and estimated conditional 5-year survival. Over time, conditional survival estimates improved for older patients with localized and regional disease. Understanding the conditional 5-year disease-specific survival of melanoma based on age and stage can help patients and physicians, informing decision-making about treatment and surveillance.
AHRQ-funded; HS020937.
Citation: Banerjee M, Lao CD, Wancata LM .
Implications of age and conditional survival estimates for patients with melanoma.
Melanoma Res 2016 Feb;26(1):77-82. doi: 10.1097/cmr.0000000000000213.
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Keywords: Elderly, Cancer: Skin Cancer, Cancer, Mortality, Skin Conditions
Hakkarainen TW, Arbabi S, Willis MM
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
This study evaluated previously independent older patients discharged to skilled nursing facilities (SNFs) and identified risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. It found that a large proportion of older patients discharging to SNFs never return home.
AHRQ-funded; HS020025.
Citation: Hakkarainen TW, Arbabi S, Willis MM .
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
Ann Surg 2016 Feb;263(2):280-5. doi: 10.1097/sla.0000000000001367..
Keywords: Critical Care, Hospitalization, Risk, Elderly, Mortality
Tamirisa NP, Parmar AD, Vargas GM
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
This study evaluated the relative contribution of overall postoperative complications and failure to rescue rates on the observed increased mortality in older patients undergoing pancreatic resection at specialized centers. In experienced hands, the rates of complications after pancreatectomy in patients 80 years or older compared to patients younger than 80 years were similar. However, when complications occurred, older patients were more likely to die.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Parmar AD, Vargas GM .
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
Ann Surg 2016 Feb;263(2):385-91. doi: 10.1097/sla.0000000000001093..
Keywords: Elderly, Mortality, Surgery, Adverse Events, Patient-Centered Outcomes Research
Bogner HR, Joo JH, Hwang S
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
The objective of this study was to determine whether treating depression decreases mortality from various chronic medical conditions. It found evidence of a statistically significant intervention effect on mortality for diabetes mellitus in persons with major depression.
AHRQ-funded; HS023445.
Citation: Bogner HR, Joo JH, Hwang S .
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
J Am Geriatr Soc 2016 Jan;64(1):126-31. doi: 10.1111/jgs.13711..
Keywords: Chronic Conditions, Depression, Elderly, Mortality, Primary Care
Green AR, Leff B, Wang Y
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
The researchers sought to determine the prevalence of frailty and dementia among older adults receiving primary prevention implantable cardioverter-defibrillators (ICDs) and to determine the impact of multimorbidity on mortality within 1 year of ICD implantation. They concluded that more than 10 percent of Medicare beneficiaries with heart failure receiving primary prevention ICDs have frailty or dementia. These patients had significantly higher 1-year mortality than those with other common chronic conditions.
AHRQ-funded; HS019814; 290201200007I.
Citation: Green AR, Leff B, Wang Y .
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
Circ Cardiovasc Qual Outcomes 2016 Jan;9(1):23-30. doi: 10.1161/circoutcomes.115.002053.
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Keywords: Elderly, Medical Devices, Mortality, Prevention, Dementia
Ghaferi AA, Dimick JB
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
The researchers reviewed the literature evaluating surgery, mortality, failure-to-rescue and the elderly. This was followed by a review of ongoing studies and unpublished work aiming to understand better the mechanisms underlying variations in surgical mortality in elderly patients. They concluded that although elderly surgical patients experienced failure-to-rescue events at much higher rates than their younger counterparts, patient-level effects did not sufficiently explain these differences.
AHRQ-funded; HS023621; HS024403; HS023597.
Citation: Ghaferi AA, Dimick JB .
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
Br J Surg 2016 Jan;103(2):e47-51. doi: 10.1002/bjs.10031.
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Keywords: Elderly, Mortality, Surgery, Teams, Patient Safety
Nagendran M, Dimick JB, Gonzalez AA
Mortality among older adults before versus after hospital transition to intensivist staffing.
The researchers sought to determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. Adoption of an intensivist staffing model was not associated with improved mortality in Medicare beneficiaries. These findings suggest that the lower mortality rates previously observed at hospitals with intensivist staffing may be attributable to other factors.
AHRQ-funded; HS023621; HS024403.
Citation: Nagendran M, Dimick JB, Gonzalez AA .
Mortality among older adults before versus after hospital transition to intensivist staffing.
Med Care 2016 Jan;54(1):67-73. doi: 10.1097/mlr.0000000000000446.
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Keywords: Mortality, Elderly, Intensive Care Unit (ICU), Hospitalization, Critical Care