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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 9 of 9 Research Studies Displayed
Adediran T, Drumheller BC, McCunn M
Sex differences in in-hospital complications among older adults after traumatic brain injury.
This study examined sex differences in in-hospital complications among older adults after traumatic brain injury (TBI). Previous evidence has suggested that women have better outcomes than men after TBI. A retrospective cohort study was conducted of adults aged 65 years and older treated for moderate to severe TBI at R. Adams Cowley Shock Trauma Center from 1996 to 2012. The investigators identified TBI using ICD-9 CM codes and inclusion in the study required an abbreviated injury scale head score of 3 or greater, abbreviated injury scale scores for other body regions of 2 or greater, and a blunt injury mechanism. Out of 2511 patients, 51.1% were men, and 25.1% developed an in-hospital complication. Men had a complication rate of 28.1% versus 22.0% for women.
Citation: Adediran T, Drumheller BC, McCunn M . Sex differences in in-hospital complications among older adults after traumatic brain injury. J Surg Res 2019 Nov;243:427-33. doi: 10.1016/j.jss.2019.05.053..
Keywords: Elderly, Sex Factors, Adverse Events, Hospitalization, Brain Injury
Hansen M, Schoonover A, Skarica B
Implicit gender bias among US resident physicians.
The purpose of this study was to characterize implicit gender bias among residents in US Emergency Medicine and OB/GYN residencies. The investigators found that gender bias was present among US residents favoring men in leadership positions, this bias differed between male and female residents, and was associated with discipline. Implicit bias did not differ across training years, and was associated with explicit bias.
Citation: Hansen M, Schoonover A, Skarica B . Implicit gender bias among US resident physicians. BMC Med Educ 2019 Oct 29;19(1):396. doi: 10.1186/s12909-019-1818-1..
Keywords: Provider, Provider: Physician, Sex Factors
Brescia AA, Wu X, Paone G
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
Researchers explored whether there a sex-related difference on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. A prospective, observational study was conducted of 17,363 patients not on dialysis undergoing the procedure between 2011 and 2016 across 41 institutions from the Perfusion Measure and Outcomes registry. There was no sex-related differences found for nadir hematocrit or rates of acute kidney injury.
AHRQ-funded; HS026003; HS022535.
Citation: Brescia AA, Wu X, Paone G . Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. J Thorac Cardiovasc Surg 2019 Oct;158(4):1073-80.e4. doi: 10.1016/j.jtcvs.2019.03.042..
Keywords: Injuries and Wounds, Sex Factors, Kidney Disease and Health, Adverse Events, Surgery, Heart Disease and Health, Cardiovascular Conditions
Purnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
Citation: Purnell TS, Luo X, Crews DC . Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States. Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
Keywords: Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
Citation: Jarman MP, Pollack Porter K, Curriero FC . Factors mediating demographic determinants of injury mortality. Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial / Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Knutsen J, Crossman M, Perrin J
Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study.
Researchers examined sex differences in clinically identified (Autism Diagnostic Observation Schedule) restricted and repetitive behavior symptoms of age-matched and intelligence quotient-matched female and male children with autism spectrum disorder. Their findings identified key restricted and repetitive behavior similarities and differences among young females and males with autism spectrum disorder and emphasized the need for a deeper understanding of the female autism phenotype.
AHRQ-funded; HS022986; HS000063.
Citation: Knutsen J, Crossman M, Perrin J . Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study. Autism 2019 May;23(4):858-68. doi: 10.1177/1362361318786490..
Keywords: Autism, Behavioral Health, Children/Adolescents, Patient-Centered Outcomes Research, Sex Factors
Khan NNS, Kelly-Blake K, Luo Z
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
The study’s purpose was to determine differences in the rate of statin prescribing by sex based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC/American Heart Association) cholesterol guidelines in Federally Qualified Health Centers (FQHCs). The study also wanted to determine adherence to those guidelines based on the 2013 recommendations. Two FQHCs were used and patients with coronary heart disease and diabetes mellitus (DM) were recruited. There was no difference between men and women in statin prescribing under ATPIII; however there was underprescribing for both men and women with atherosclerotic cardiovascular disease (ASCVD).
Citation: Khan NNS, Kelly-Blake K, Luo Z . Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines. Health Serv Res Manag Epidemiol 2019 Mar 5;6:2333392818825414. doi: 10.1177/2333392818825414..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Practice Patterns, Sex Factors
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN . Gender disparities in trauma care: how sex determines treatment, behavior, and outcome. Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M . Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients. Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Dialysis, Disparities, Elderly, Outcomes, Patient-Centered Outcomes Research, Sex Factors, Surgery