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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 15 of 15 Research Studies Displayed
Haessler S, Guo N, Deshpande A
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
This study compared the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. The definition for sCAP includes a principal diagnosis of pneumonia or a secondary pneumonia diagnosis paired with a principal diagnosis of sepsis or respiratory failure. One-hundred seventy-seven US hospitals within the Premier Healthcare Database were used to identify 154,799 patients with pneumonia, with 14.1% meeting criteria for sCAP. The sCAP patients had higher organ failure scores and inpatient mortality, longer lengths of stay, and higher costs than those with nonsevere disease. Patients with sCAP had twice the rate of positive blood cultures and respiratory cultures and more often had isolates resistant to first-line community-acquired pneumonia antibiotics. The most common pathogen acquired from blood cultures was Streptococcus pneumoniae and from the respiratory tract Staphylococcus aureus and Pseudomonas species. The most common antibiotics prescribed were vancomycin (65%) and piperacillin-tazobactam (42.8%), regardless of cultures positive for a resistant organism.
Citation: Haessler S, Guo N, Deshpande A . Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample. Crit Care Med 2022 Jul;50(7):1063-71. doi: 10.1097/ccm.0000000000005498..
Keywords: Community-Acquired Infections, Pneumonia, Respiratory Conditions, Outcomes
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.
The purpose of this AHRQ-authored cross-sectional study was to assess whether patients with pneumonia who were admitted to hospitals with higher risk-standardized readmission rates had a higher risk of in-hospital adverse events. The researchers linked patient-level adverse events data from the Medicare Patient Safety Monitoring System (MPSMS) to the hospital-level pneumonia-specific all-cause readmissions data from the Centers for Medicare & Medicaid Services. The MPSMS data included 46,047 patients with pneumonia across 2,590 hospitals discharged from July 1, 2010, through December 31, 2019. For data from 2010 to 2017, analysis was completed from October 2019 through July 2020, and for data from 2018 to 2019 analysis was completed from March through April 2022. The study concluded that readmission rates are associated with the quality of hospital care for pneumonia; patients with pneumonia admitted to hospitals with high all-cause readmission rates had a higher likelihood of developing adverse events during the initial hospitalization.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Wang Y, Eldridge N, Metersky ML . Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States. JAMA Netw Open 2022 May 2;5(5):e2214586. doi: 10.1001/jamanetworkopen.2022.14586..
Keywords: Hospital Readmissions, Hospitals, Adverse Events, Pneumonia, Respiratory Conditions
Bartley PS, Deshpande A, Yu PC
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Among patients hospitalized for influenza pneumonia, the researchers reported the rate of coinfection and distribution of pathogens and also compared outcomes of patients with and without bacterial coinfection. They found that, in a large US inpatient sample hospitalized with influenza and community-acquired pneumonia, Staphylococcus aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
Citation: Bartley PS, Deshpande A, Yu PC . Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes. Infect Control Hosp Epidemiol 2022 Feb;43(2):212-17. doi: 10.1017/ice.2021.96..
Keywords: Influenza, Pneumonia, Infectious Diseases, Community-Acquired Infections
Rastogi R, Yu PC, Deshpande A
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
This retrospective cohort study’s objective was to describe community-acquired pneumonia (CAP) among patients ≥85 years and compare them to patients aged 65-74. Findings showed that patients aged 85 and over have different comorbidities and etiologies of CAP, receive less intense treatment, and have greater mortality than patients between 65 and 75 years.
Citation: Rastogi R, Yu PC, Deshpande A . Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia. J Investig Med 2022 Feb;70(2):376-82. doi: 10.1136/jim-2021-002078..
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Outcomes, Hospitalization
Albright K, Hurley LP, Lockhart S
Attitudes about adult vaccines and reminder/recall in a safety net population.
The objective of this study was to determine patient perspectives on adult vaccines generally; attitudes about Tdap, pneumococcal polysaccharide (PPSV-23), and seasonal influenza vaccines specifically; and preferences for adult reminder/recall delivery.
Citation: Albright K, Hurley LP, Lockhart S . Attitudes about adult vaccines and reminder/recall in a safety net population. Vaccine 2017 Dec 19;35(52):7292-96. doi: 10.1016/j.vaccine.2017.11.001..
Keywords: Influenza, Pneumonia, Prevention, Safety Net, Vaccination
Ho V, Ross JS, Steiner CA
AHRQ Author: Steiner CA
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. This study in 28 states found that smoking bans lowered pneumonia hospitalization rates for persons ages 60 to 74 years and higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74.
Citation: Ho V, Ross JS, Steiner CA . A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia. Med Care Res Rev 2017 Dec;74(6):687-704. doi: 10.1177/1077558716668646.
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospitalization, Pneumonia, Tobacco Use
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
Citation: Haessler S, Lagu T, Lindenauer PK . Treatment trends and outcomes in healthcare-associated pneumonia. J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
McFarland M, Szasz TP, Zhou JY
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
The primary goal of this study was to determine the vaccine-type (VT) serotype prevalence of nasopharyngeal (NP) pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent pneumococcal conjugate vaccine in 2010. It concluded that children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US.
AHRQ-funded; HS021736; HS024269.
Citation: McFarland M, Szasz TP, Zhou JY . Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA. Vaccine 2017 Aug 3;35(34):4389-95. doi: 10.1016/j.vaccine.2017.06.047.
Keywords: Vaccination, Children/Adolescents, Pneumonia, Infectious Diseases
Boltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
Citation: Boltey E, Yakusheva O, Costa DK . 5 nursing strategies to prevent ventilator-associated pneumonia. Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Meystre S, Gouripeddi R, Tieder J
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. It found that, when compared with each of the domain experts manually annotating these reports, the new Natural Language Processing (NLP) application developed by the researchers allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity.
Citation: Meystre S, Gouripeddi R, Tieder J . Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study. J Med Internet Res 2017 May 15;19(5):e162. doi: 10.2196/jmir.6887.
Keywords: Children/Adolescents, Community-Acquired Infections, Comparative Effectiveness, Health Information Technology (HIT), Pneumonia
Brown T, Goldman SN, Persell SD
Development and evaluation of a patient education video promoting pneumococcal vaccination.
The researchers aimed to develop and refine a patient education video about pneumococcal polysaccharide vaccination (PPSV23) and to assess patient perceptions regarding video content and receipt of video during a clinic visit. They found that focus group participants had positive reactions to the video but suggested reducing the intensity of messages about pneumonia severity. Participants shown the revised video during a clinic visit perceived it to be easy to understand and informative.
Citation: Brown T, Goldman SN, Persell SD . Development and evaluation of a patient education video promoting pneumococcal vaccination. Patient Educ Couns 2017 May;100(5):1024-27. doi: 10.1016/j.pec.2016.12.025.
Keywords: Education: Patient and Caregiver, Health Promotion, Pneumonia, Vaccination
Iroh Tam PY, Thielen BK, Obaro SK
Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility.
This study provided updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa. It concluded that, although the incidence of invasive pneumococcal disease (IPD) in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes.
Citation: Iroh Tam PY, Thielen BK, Obaro SK . Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility. Vaccine 2017 Apr 4;35(15):1817-27. doi: 10.1016/j.vaccine.2017.02.045.
Keywords: Children/Adolescents, Infectious Diseases, Medication, Pneumonia, Vaccination
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
Citation: Makam AN, Nguyen OK, Clark C . Predicting 30-day pneumonia readmissions using electronic health record data. J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
Citation: Frei CR, Rehani S, Lee GC . Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy. Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Nace DA, Archbald-Pannone LR, Ashraf MS
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex. The authors discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
Citation: Nace DA, Archbald-Pannone LR, Ashraf MS . Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee. J Am Med Dir Assoc 2017 Feb;18(2):99-104. doi: 10.1016/j.jamda.2016.11.010.
Keywords: Elderly, Guidelines, Nursing Homes, Pneumonia, Vaccination