National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Adverse Events (5)
- Cancer (1)
- Cardiovascular Conditions (5)
- Comparative Effectiveness (1)
- Data (1)
- Dialysis (1)
- Elderly (4)
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- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (2)
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- (-) Mortality (13)
- Outcomes (6)
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- Rehabilitation (1)
- (-) Risk (13)
- (-) Surgery (13)
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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 13 of 13 Research Studies DisplayedBath J, Smith JB, Woodard J
Complex relationship between low albumin level and poor outcome after lower extremity procedures for peripheral artery disease.
Researchers sought to examine the association of low albumin level with outcomes in patients undergoing open and endovascular lower extremity procedures for peripheral artery disease. Subjects were patients with peripheral artery disease undergoing lower extremity procedures, selected from Cerner Health Facts database using ICD-9 diagnosis and procedure codes. They found that low preoperative albumin levels were associated with in-hospital death, prolonged length of stay, and severe morbidity after open and endovascular lower extremity procedures. They recommended that elective procedures be deferred until albumin levels have been optimized.
Citation: Bath J, Smith JB, Woodard J .
Complex relationship between low albumin level and poor outcome after lower extremity procedures for peripheral artery disease.
J Vasc Surg 2021 Jan;73(1):200-09. doi: 10.1016/j.jvs.2020.04.524..
Keywords: Cardiovascular Conditions, Surgery, Outcomes, Mortality, Risk
McIsaac DI, Taljaard M, Bryson GL
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
The purpose of this study was to compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. Results showed that older people with frailty are significantly more likely to die or experience a new patient-reported disability after surgery and that although accuracy was similar, the CFS, compared to the mFI, was easier to use and feasibility was higher.
AHRQ-funded; HS023313.
Citation: McIsaac DI, Taljaard M, Bryson GL .
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
Ann Surg 2020 Feb;271(2):283-89. doi: 10.1097/sla.0000000000002967..
Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Mortality, Adverse Events, Risk, Outcomes
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Xu X, Lin H, Wright JD
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
Despite concerns that power morcellation may adversely affect prognosis of patients with occult uterine cancer, empirical evidence has been limited and inconclusive. In this study, the investigators aimed to determine whether uncontained power morcellation at the time of hysterectomy or myomectomy was associated with increased mortality risk in women with occult uterine cancer.
AHRQ-funded; HS024702.
Citation: Xu X, Lin H, Wright JD .
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
J Clin Oncol 2019 Dec 10;37(35):3412-24. doi: 10.1200/jco.19.00562..
Keywords: Cancer, Mortality, Women, Surgery, Risk, Adverse Events
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Mehta HB, Yong S, Sura SD
Development of comorbidity score for patients undergoing major surgery.
The goal of this study was to develop and validate a claims-based comorbidity score and compare to established comorbidity scores. The researchers used Medicare data to find adults 65 and older who had undergone major surgery to predict 1-year mortality, and 30-day hospital readmission. The comorbidity score was compared to the Charlson, Elixhauser, and CMC-HCC scores. Their newly developed comorbidity score better predicted outcomes than the established comorbidity score systems in the surgical population.
AHRQ-funded; HS022134.
Citation: Mehta HB, Yong S, Sura SD .
Development of comorbidity score for patients undergoing major surgery.
Health Serv Res 2019 Dec;54(6):1223-32. doi: 10.1111/1475-6773.13209..
Keywords: Surgery, Risk, Mortality
Fritz BA, Cui Z, Zhang M
Deep-learning model for predicting 30-day postoperative mortality.
The currently available prediction tools using summaries of intraoperative data are limited by their inability to reflect shifting risk associated with intraoperative physiological perturbations. In this study the investigators sought to compare similar benchmarks to a deep-learning algorithm predicting postoperative 30-day mortality. They concluded that a deep-learning time-series model improved prediction compared with models with simple summaries of intraoperative data.
AHRQ-funded; HS024581.
Citation: Fritz BA, Cui Z, Zhang M .
Deep-learning model for predicting 30-day postoperative mortality.
Br J Anaesth 2019 Nov;123(5):688-95. doi: 10.1016/j.bja.2019.07.025..
Keywords: Adverse Events, Health Information Technology (HIT), Mortality, Risk, Surgery
Kundi H, Popma JJ, Valsdottir LR
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
The goals of this study were to identify nontraditional risk factors coded in administrative claims data and to evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair. Patients undergoing transcatheter mitral valve repair using MitraClip implantation were identified among Medicare fee-for-service beneficiaries; researchers used nested Cox regression models to identify claims codes predictive of long-term mortality. Four groups of variables were introduced: cardiac, noncardiac, and nontraditional risk factors, and presentation characteristics. The authors conclude that risk-prediction models, which include nontraditional risk factors as identified in claims data, can be used to predict long-term mortality risk more accurately in patients who have undergone MitraClip procedures.
AHRQ-funded; HS024520.
Citation: Kundi H, Popma JJ, Valsdottir LR .
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
Can J Cardiol 2018 Dec;34(12):1648-54. doi: 10.1016/j.cjca.2018.10.002..
Keywords: Cardiovascular Conditions, Elderly, Mortality, Heart Disease and Health, Medicare, Risk, Surgery
Hannan EL, Barrett SC, Samadashvili Z
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
This study assessed the feasibility of retooling the paper-based New York State coronary artery bypass graft (CABG) surgery statistical model for mortality and readmission into a model for electronic health records (EHRs). Researchers found that only 6 data elements could be extracted from the EHR, and outlier hospitals differed for readmission but was usable for mortality. They concluded that the EHR model was inferior to the NYS model, and that simplifying the EHR risk model couldn’t capture most of the risk factors in the NYS model.
AHRQ-funded; HS022647.
Citation: Hannan EL, Barrett SC, Samadashvili Z .
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
Med Care 2019 May;57(5):377-84. doi: 10.1097/mlr.0000000000001104..
Keywords: Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Outcomes, Risk, Cardiovascular Conditions
Wey A, Salkowski N, Kasiske BL
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
To improve accessibility of program-specific reports to patients, the Scientific Registry of Transplant Recipients released a 5-tier system for categorizing 1-year posttransplant program evaluations. Whether this system predicts subsequent posttransplant outcomes at the time patients are waitlisted has been questioned. IN this study, researchers investigated the association of tier at listing and the corresponding continuous score used for tier assignment, which ranges from 0 (poor outcomes) to 1 (good outcomes), with eventual 1-year posttransplant graft survival.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
Am J Transplant 2019 Feb;19(2):391-98. doi: 10.1111/ajt.15038..
Keywords: Transplantation, Surgery, Mortality, Registries, Adverse Events, Risk
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Hannan EL, Qian F, Pine M
The value of adding laboratory data to coronary artery bypass grafting registry data to improve models for risk-adjusting provider mortality rates.
The purpose of this study was to determine whether the addition of laboratory data to the clinical database for coronary artery bypass graft (CABG) would identify laboratory variables that are significant independent predictors of short-term (in-hospital / 30-day) mortality. The researchers found that there was no significant difference in the discrimination of the registry model or the combined registry/laboratory model.
AHRQ-funded; HS019965.
Citation: Hannan EL, Qian F, Pine M .
The value of adding laboratory data to coronary artery bypass grafting registry data to improve models for risk-adjusting provider mortality rates.
Ann Thorac Surg 2015 Feb;99(2):495-501. doi: 10.1016/j.athoracsur.2014.08.043..
Keywords: Registries, Mortality, Risk, Surgery, Data
Huesch MD
The impact of short breaks from cardiac surgery on mortality and stay length in California.
In this small, exploratory study, the researchers sought to investigate potential surgical “forgetting” among cardiac surgeons taking a break from performing isolated coronary artery bypass graft (CABG) surgery in a large state-wide study in California. Patients operated on by surgeons who had not performed isolated CABG in the prior calendar month stayed in hospital 0.5 day longer.
AHRQ-funded; HS021868.
Citation: Huesch MD .
The impact of short breaks from cardiac surgery on mortality and stay length in California.
J Healthc Qual 2014 Sep-Oct;36(5):42-9. doi: 10.1111/jhq.12018..
Keywords: Surgery, Outcomes, Mortality, Risk