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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
951 to 975 of 1110 Research Studies DisplayedWasserstein D, Huston LJ, Nwosu S
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
The researchers applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an anterior cruciate ligament reconstruction (ACLR) cohort to identify prevalence and risk factors. They concluded that significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk.
AHRQ-funded; HS016075.
Citation: Wasserstein D, Huston LJ, Nwosu S .
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
Osteoarthritis Cartilage 2015 Oct;23(10):1674-84. doi: 10.1016/j.joca.2015.05.025..
Keywords: Arthritis, Surgery, Pain, Chronic Conditions, Outcomes
McNamara ER, Schaeffer AJ, Logvinenko T
Management of proximal hypospadias with 2-stage repair: 20-year experience.
The researchers describe their experience with 2-stage proximal hypospadias repair. They report outcomes, and patient and procedure characteristics associated with surgical complications. In their review of the largest cohort of patients undergoing this procedure at a single institution, they found that complications and, reoperation rates were approximately 50 percent in the setting of complex genital reconstruction.
AHRQ-funded; HS000063.
Citation: McNamara ER, Schaeffer AJ, Logvinenko T .
Management of proximal hypospadias with 2-stage repair: 20-year experience.
J Urol 2015 Oct;194(4):1080-5. doi: 10.1016/j.juro.2015.04.105..
Keywords: Newborns/Infants, Outcomes, Surgery, Adverse Events
Patorno E, Wang SV, Schneeweiss S
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
The objective of this study is to examine patterns of β-Blocker initiation among patients undergoing noncardiac elective surgery in the US. It concluded that after a period of a rapidly increasing trend, perioperative β-Blocker initiation decreased sharply in the second half of 2008 and continued to decrease afterwards.
AHRQ-funded; HS022193.
Citation: Patorno E, Wang SV, Schneeweiss S .
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
Am Heart J 2015 Oct;170(4):812-20.e6. doi: 10.1016/j.ahj.2015.06.028..
Keywords: Surgery, Patient-Centered Outcomes Research, Patient Safety, Medication
Wiseman JT, Fernandes-Taylor S, Barnes ML
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
This study explored the factors that lead to postdischarge surgical site infections (SSI), investigated the differences between risk factors for in-hospital vs postdischarge SSI, and developed a scoring system to identify patients who might benefit from postdischarge monitoring of their wounds. In a comparative analysis, it found that comorbidities were the primary driver of postdischarge SSI, whereas in-hospital factors (operative time, emergency case status) and complications predicted in-hospital SSI.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
J Vasc Surg 2015 Oct;62(4):1023-31.e5. doi: 10.1016/j.jvs.2015.04.453..
Keywords: Surgery, Hospital Discharge, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Carey K
Price increases were much lower in ambulatory surgery centers than hospital outpatient departments in 2007-12.
This study examined the revenue side of ASC growth by using a large national claims database that contains information on actual prices paid. It found that for six common outpatient surgical procedures, prices paid to ASCs on the whole grew in line with general medical care prices, while overall prices paid to hospital outpatient departments for the same procedures climbed sharply.
AHRQ-funded; HS023780.
Citation: Carey K .
Price increases were much lower in ambulatory surgery centers than hospital outpatient departments in 2007-12.
Health Aff 2015 Oct;34(10):1738-44. doi: 10.1377/hlthaff.2015.0252..
Keywords: Ambulatory Care and Surgery, Healthcare Costs, Surgery
Alruwaily AF, Eisner BH, Bierlein MJ
Statin use and risk of sepsis after percutaneous nephrolithotomy.
The researchers examined the association between statin medication use and sepsis risk after percutaneous nephrolithotomy (PCNL). They found that statin use is not associated with reductions in postoperative sepsis, nonfebrile urinary tract infections, ICU utilization, or hospital length of stay after PCNL.
AHRQ-funded; HS020927.
Citation: Alruwaily AF, Eisner BH, Bierlein MJ .
Statin use and risk of sepsis after percutaneous nephrolithotomy.
J Endourol 2015 Oct;29(10):1126-30. doi: 10.1089/end.2015.0042..
Keywords: Medication, Risk, Surgery, Adverse Events, Patient Safety
Acher AW, LeCaire TJ, Hundt AS
Using human factors and systems engineering to evaluate readmission after complex surgery.
The study objective was to use a human factors and systems engineering approach to understand contributors to surgical readmissions from a patient and provider perspective. Patients and clinician providers identified a number of factors during the transition of care that may have contributed to readmission, including poor patient and caregiver understanding; inadequate discharge preparation for home care; insufficient educational process and materials.
AHRQ-funded; HS022446.
Citation: Acher AW, LeCaire TJ, Hundt AS .
Using human factors and systems engineering to evaluate readmission after complex surgery.
J Am Coll Surg 2015 Oct;221(4):810-20. doi: 10.1016/j.jamcollsurg.2015.06.014..
Keywords: Surgery, Hospital Readmissions, Hospital Discharge, Transitions of Care, Electronic Health Records (EHRs)
Robinson JC, Brown TT, Whaley C
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
The purpose of this study was to evaluate the impact of reference-based benefits on consumer choices, facility prices, employer spending, and surgical outcomes for orthopaedic procedures performed at ambulatory surgery centers. It found that the shift to reference-based benefits was associated with an increase in the utilization of freestanding ambulatory surgery centers by 14.3 percentage points for knee arthroscopy and by 9.9 percentage points for shoulder arthroscopy and a corresponding decrease in the use of hospital-based facilities.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
J Bone Joint Surg Am 2015 Sep 16;97(18):1473-81. doi: 10.2106/jbjs.o.00240..
Keywords: Surgery, Ambulatory Care and Surgery, Outcomes
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
This study evaluated outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with chronic kidney disease (CKD). It found that In patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps heart attack, with no long-term mortality difference.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
J Am Coll Cardiol 2015 Sep 15;66(11):1209-20. doi: 10.1016/j.jacc.2015.06.1334..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Surgery, Kidney Disease and Health
Maradit kremers H, Larson DR, Crowson CS
AHRQ Author: Washington RE, Steiner CA
Prevalence of total hip and knee replacement in the United States.
The study’s objective was to estimate the prevalence of total hip and total knee replacement in the United States. It found that the 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83 percent and 1.52 percent, respectively. Prevalence was higher among women than among men and increased with age.
AHRQ-authored
Citation: Maradit kremers H, Larson DR, Crowson CS .
Prevalence of total hip and knee replacement in the United States.
J Bone Joint Surg Am 2015 Sep 2;97(17):1386-97. doi: 10.2106/jbjs.n.01141..
Keywords: Healthcare Cost and Utilization Project (HCUP), Arthritis, Surgery
Rajaram R, Chung JW, Cohen ME
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
The 2011 ACGME resident duty hour reform implemented additional restrictions to existing duty hour policies. The study’s objective was to determine the association between this reform and patient outcomes among several surgical specialties. It found that implementation of the 2011 ACGME resident duty hour reform was not associated with a significant change in patient outcomes for several surgical specialties in the 2 years after reform.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Cohen ME .
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
J Am Coll Surg 2015 Sep;221(3):748-57. doi: 10.1016/j.jamcollsurg.2015.06.010..
Keywords: Education: Continuing Medical Education, Outcomes, Surgery, Training
Wiseman JT, Fernandes-Taylor S, Barnes ML
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
The researchers surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. Their survey demonstrated that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
J Surg Res 2015 Sep;198(1):245-51. doi: 10.1016/j.jss.2015.05.011..
Keywords: Ambulatory Care and Surgery, Surgery, Telehealth, Health Information Technology (HIT), Injuries and Wounds, Adverse Events, Patient Safety, Caregiving
Waljee JF
Discussion: Are quantitative measures of academic productivity correlated with academic rank in plastic surgery? A national study.
The author argues that although bibliometric indices are a readily available assessment of scholarly productivity, important unanswered questions remain regarding their applications and limitations as measures of academic performance.
AHRQ-funded; HS023313.
Citation: Waljee JF .
Discussion: Are quantitative measures of academic productivity correlated with academic rank in plastic surgery? A national study.
Plast Reconstr Surg 2015 Sep;136(3):622-3. doi: 10.1097/prs.0000000000001566..
Keywords: Provider, Provider Performance, Surgery
Beffa LR, Petroski GF, Kruse RL
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
The authors evaluated the effects of elective open AAA repair (OAR) and endovascular AAA repair (EVAR) and evaluated comorbidities for their impact on functional trajectories after discharge. They found that procedure type was not significantly related to postoperative function or to the subsequent rate of improvement. OAR and EVAR were associated with similar initial declines and comparable postoperative trajectories, suggesting that less invasive EVAR was not associated with improved functional preservation compared with OAR. Longer stays were associated with poorer functional trajectories.
AHRQ-funded; HS022140.
Citation: Beffa LR, Petroski GF, Kruse RL .
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
J Vasc Nurs 2015 Sep;33(3):106-11. doi: 10.1016/j.jvn.2015.02.003.
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Keywords: Adverse Events, Elderly, Nursing Homes, Patient-Centered Outcomes Research, Surgery
Zanocco K, Butt Z, Kaltman D
Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism.
The objective of this study was to evaluate the feasibility of Patient-Reported Outcomes Measurement Information System (PROMIS) assessment in the clinical setting to measure changes in patient-reported health before and after parathyroidectomy. It found that PROMIS is an efficient clinical assessment platform for measuring patient-reported outcomes in primary hyperparathyroidism via computer-adaptive testing.
AHRQ-funded; HS000078.
Citation: Zanocco K, Butt Z, Kaltman D .
Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism.
Surgery 2015 Sep;158(3):837-45. doi: 10.1016/j.surg.2015.03.054..
Keywords: Health Status, Surgery, Behavioral Health, Patient-Centered Outcomes Research, Outcomes
Thompson DA, Marsteller JA, Pronovost PJ
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
The objectives of the study were to develop a scientifically sound and feasible peer-to-peer assessment model that allows health-care organizations to evaluate patient safety in cardiovascular operating rooms and to establish safety priorities for improvement. It identified 6 top priority hazard themes: safety culture, teamwork and communication, infection prevention, transitions of care, failure to adhere to practices or policies, and operating room layout and equipment.
AHRQ-funded; HS013904.
Citation: Thompson DA, Marsteller JA, Pronovost PJ .
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
J Patient Saf 2015 Sep;11(3):143-51. doi: 10.1097/pts.0000000000000059..
Keywords: Patient Safety, Medical Errors, Adverse Events, Surgery, Cardiovascular Conditions, Prevention
McElroy LM, Collins KM, Koller FL
Operating room to intensive care unit handoffs and the risks of patient harm.
The goal of this study was to assess systems and processes involved in the operating room(OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. In total, 81 process failures were identified, Process failures with the greatest risk of harm were lack of preliminary OR to ICU communication, team member absence during handoff communication, and transport equipment malfunction.
AHRQ-funded; HS000078.
Citation: McElroy LM, Collins KM, Koller FL .
Operating room to intensive care unit handoffs and the risks of patient harm.
Surgery 2015 Sep;158(3):588-94. doi: 10.1016/j.surg.2015.03.061..
Keywords: Intensive Care Unit (ICU), Patient Safety, Surgery, Communication, Adverse Events
Likosky DS, Paone G, Zhang M
Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting.
This study describes the relationship between red blood cell (RBC) transfusion and postoperative pneumonia after CABG. It found a significant volume dependent association between an increasing number of RBCs and the odds of pneumonia, which persisted after risk adjustment. It included a total of 16,182 consecutive patients who underwent isolated CABG between 2011 and 2013 at 1 of 33 hospitals in the state of Michigan.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Paone G, Zhang M .
Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting.
Ann Thorac Surg 2015 Sep;100(3):794-801. doi: 10.1016/j.athoracsur.2015.03.089..
Keywords: Surgery, Cardiovascular Conditions, Patient Safety
Durkin MJ, Dicks KV, Baker AW
Seasonal variation of common surgical site infections: does season matter?
The researchers evaluated seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures. Using data from the Duke Infection Control Outreach Network, they found that the rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Seasonal variation of common surgical site infections: does season matter?
Infect Control Hosp Epidemiol 2015 Sep;36(9):1011-6. doi: 10.1017/ice.2015.121.
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Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Injuries and Wounds
Abdelsattar ZM, Birkmeyer JD, Wong SL
Variation in Medicare payments for colorectal cancer surgery.
The researchers assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variation in payment for colorectal cancer surgery (CRC). They concluded that Medicare spending in the first year after CRC surgery varies across hospitals even after case-mix adjustment and price standardization. Variation is largely driven by postacute care and not the index surgical hospitalization.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Birkmeyer JD, Wong SL .
Variation in Medicare payments for colorectal cancer surgery.
J Oncol Pract 2015 Sep;11(5):391-5. doi: 10.1200/jop.2015.004036.
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Keywords: Cancer, Cancer: Colorectal Cancer, Payment, Medicare, Surgery
Brooke BS, Goodney PP, Kraiss LW
Readmission destination and risk of mortality after major surgery: an observational cohort study.
This study examined the association between readmission destination and mortality risk in the USA in Medicare beneficiaries after a range of common operations. It found that patients who are readmitted to hospital after various major operations consistently achieve improved survival if they return to the hospital where their surgery took place.
AHRQ-funded; HS021581.
Citation: Brooke BS, Goodney PP, Kraiss LW .
Readmission destination and risk of mortality after major surgery: an observational cohort study.
Lancet 2015 Aug 29;386(9996):884-95. doi: 10.1016/s0140-6736(15)60087-3..
Keywords: Hospital Readmissions, Mortality, Surgery, Elderly, Outcomes, Hospitals
Bewtra M, Newcomb CW, Wu Q
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
This study sought to determine whether patients with advanced ulcerative colitis (UC) treated with elective colectomy have improved survival compared with those treated with medical therapy. It found that elective colectomy was associated with improved survival compared with long-term medical therapy, although this result did not remain statistically significant in all sensitivity analyses.
AHRQ-funded; HS018517.
Citation: Bewtra M, Newcomb CW, Wu Q .
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Ann Intern Med 2015 Aug 18;163(4):262-70. doi: 10.7326/m14-0960..
Keywords: Comparative Effectiveness, Mortality, Outcomes, Surgery, Digestive Disease and Health
McNamara ER, Kurtz MP, Schaeffer AJ
30-day morbidity after augmentation enterocystoplasty and appendicovesicostomy: a NSQIP pediatric analysis.
The researchers report 30-day outcomes from the first nationally based, prospectively assembled cohort of pediatric patients undergoing these complex pediatric urologic procedures. There were a total of 110 National Surgical Quality Improvement Program (NSQIP) complications seen in 87 patients. The most common complication was urinary tract infection. The composite measure of any 30- day event was seen in 27.8 percent of the cohort.
AHRQ-funded; HS000063.
Citation: McNamara ER, Kurtz MP, Schaeffer AJ .
30-day morbidity after augmentation enterocystoplasty and appendicovesicostomy: a NSQIP pediatric analysis.
J Pediatr Urol 2015 Aug;11(4):209.e1-6. doi: 10.1016/j.jpurol.2015.04.016..
Keywords: Children/Adolescents, Outcomes, Surgery, Adverse Events, Quality Improvement
Kurtz MP, McNamara ER, Schaeffer AJ
Association of BMI and pediatric urologic postoperative events: results from pediatric NSQIP.
The researchers sought to determine the association of elevated BMI with overall 30-day postoperative events and wound complications in a large national sample of children undergoing urologic procedures. They concluded that BMI in the pediatric National Surgical Quality Improvement Program urologic population was found to be associated with overall complication after adjustment for case type and preoperative comorbidity.
AHRQ-funded; HS000063.
Citation: Kurtz MP, McNamara ER, Schaeffer AJ .
Association of BMI and pediatric urologic postoperative events: results from pediatric NSQIP.
J Pediatr Urol 2015 Aug;11(4):224.e1-6. doi: 10.1016/j.jpurol.2015.04.014..
Keywords: Surgery, Children/Adolescents, Obesity, Risk, Adverse Events
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
AHRQ-funded; H0S19455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data