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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.
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1 to 8 of 8 Research Studies DisplayedDeshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
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.
AHRQ-funded; HS024277.
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
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.
AHRQ-funded; HS024277.
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
Thomson J, Hall M, Ambroggio L
Antibiotics for aspiration pneumonia in neurologically impaired children.
The objective of the study was to compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). The investigators concluded that anaerobic therapy appeared to be important in the treatment of aspiration pneumonia in children with NI. They suggested that while Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Ambroggio L .
Antibiotics for aspiration pneumonia in neurologically impaired children.
J Hosp Med 2020 Jul;15(7):395-402. doi: 10.12788/jhm.3338..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Neurological Disorders, Antibiotics, Medication, Outcomes
Gupta NM, Lindenauer PK, Yu PC
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
The purpose of this study was to compare the causes, treatment, and outcomes of pneumonia in patients with and without alcohol use disorder (AUD). Results suggest that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The authors conclude that higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
AHRQ-funded; HS024277; HS025026.
Citation: Gupta NM, Lindenauer PK, Yu PC .
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
JAMA Netw Open 2019 Jun 5;2(6):e195172. doi: 10.1001/jamanetworkopen.2019.5172..
Keywords: Alcohol Use, Community-Acquired Infections, Hospitalization, Outcomes, Pneumonia, Substance Abuse
Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Pneumonia is a leading cause of pediatric admissions. Although air pollutants are associated with poor outcomes, few national studies have examined associations between pollutant levels and inpatient pediatric pneumonia outcomes. In this study, the investigators examined the relationship between ozone (O3) and fine particulate matter with a diameter </=2.5 microm (PM2.5) and outcomes related to disease severity. They concluded that greater levels of O3 and PM2.5 were associated with more severe presentations of pneumonia.
AHRQ-authored
Citation: Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH .
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Acad Pediatr 2019 May - Jun;19(4):414-20. doi: 10.1016/j.acap.2018.12.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Hospitalization, Outcomes
Likosky DS, Harrington SD, Cabrera L
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
This study examined post cardiac surgery pneumonia rates associated with participation in a statewide, quality improvement collaborative relative to a national physician reporting program. The investigators concluded that participation in a physician-led collaborative was associated with significant reductions in pneumonia relative to a national quality reporting program. They suggest that interventions including collaborative learning may yield superior outcomes relative to solely using physician feedback reporting.
AHRQ-funded; HS022535.
Citation: Likosky DS, Harrington SD, Cabrera L .
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e004756. doi: 10.1161/circoutcomes.118.004756..
Keywords: Outcomes, Patient Safety, Pneumonia, Quality of Care, Quality Improvement, Surgery
Thompson MP, Cabrera L, Strobel RJ
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Postoperative pneumonia is the most common healthcare-associated infection in cardiac surgical patients, yet their impact across a 90-day episode of care remains unknown. The objective of this study was to examine the relationship between pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. The investigators concluded that postoperative pneumonia was associated with significantly higher 90-day episode payments and inferior outcomes at the patient and hospital level.
AHRQ-funded; HS022535.
Citation: Thompson MP, Cabrera L, Strobel RJ .
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Circ Cardiovasc Qual Outcomes 2018 Sep;11(9):e004818. doi: 10.1161/circoutcomes.118.004818..
Keywords: Elderly, Surgery, Medicare, Cardiovascular Conditions, Heart Disease and Health, Pneumonia, Payment, Healthcare Costs, Outcomes, Healthcare-Associated Infections (HAIs), Health Insurance
