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AHRQ Research Studies
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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.
Results
1 to 13 of 13 Research Studies Displayed
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation:
Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords:
COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Gershengorn HB, Hu Y, Chen JT
The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19.
This study looked at the effects of the use of high-flow nasal cannula for COVID-19 patients on mortality and the availability of mechanical ventilators. The authors constructed dynamical simulation models of high-flow nasal cannula and mechanical ventilation use in the United States. There were two outcomes looked for: 1) cumulative number of deaths; and 2) days without available ventilators. The strategy resulted in an estimated number of 10,000-40,000 fewer deaths than if high-flow nasal cannula were not available. This strategy also led up to 25 fewer days without available ventilators.
AHRQ-funded; HS026188.
Citation:
Gershengorn HB, Hu Y, Chen JT .
The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19.
Ann Am Thorac Soc 2021 Apr;18(4):623-31. doi: 10.1513/AnnalsATS.202007-803OC..
Keywords:
COVID-19, Respiratory Conditions, Mortality, Critical Care
Collinsworth AW, Priest EL, Masica AL
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
This study examined the cost-effectiveness of the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle intervention to improve short- and long-term clinical outcomes for patients requiring ICU care. A 2-year, prospective, cost-effectiveness study in 12 adult ICUs in six hospitals belonging to a large, integrated healthcare delivery system was conducted. Hospitals in the study included a large, urban center and five community hospitals. ICU types included medical/surgical, trauma, neurologic, and cardiac care units. The cohort included 2,953 adults with an ICU stay greater than 24 hours who were on a ventilator for more than 24 hours and less than 14 days. ICUs with high ABCDE bundle adherence significantly decreased odds of inpatient mortality and had significantly higher costs of inpatient care. The incremental cost-effectiveness ratio of high bundle adherence was $15,077 per life saved, and $1,057 per life-year saved.
AHRQ-funded; HS021459.
Citation:
Collinsworth AW, Priest EL, Masica AL .
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
Crit Care Med 2020 Dec;48(12):1752-59. doi: 10.1097/ccm.0000000000004609..
Keywords:
Intensive Care Unit (ICU), Critical Care, Mortality, Healthcare Costs
Tignanelli CJ, Sheetz KH, Petersen A
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes. Data from the Healthcare Cost and Utilization Project's state inpatient databases was utilized from 2010 - 2014. A multilevel logistic regression model was used to evaluate the relationship between NC and clinical outcomes. The investigators concluded that rates of NC were low in critically ill patients.
AHRQ-funded; HS026379.
Citation:
Tignanelli CJ, Sheetz KH, Petersen A .
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
JPEN J Parenter Enteral Nutr 2020 Feb;44(2):213-19. doi: 10.1002/jpen.1534..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Intensive Care Unit (ICU), Nutrition, Patient-Centered Outcomes Research, Outcomes, Critical Care, Mortality
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation:
Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords:
Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Pepper DJ, Sun J, Rhee C
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
This study is a systematic review and meta-analysis on survival outcomes of using procalcitonin (PCT)-guided antibiotic discontinuation on critically ill adults. The study quality was assessing with the Cochrane risk of bias tool, and GRADEpro was used to grade evidence. PCT-guided discontinuation was associated with decreased mortality, but there was a high risk of bias in many of the studies reviewed with a low certainty of evidence. The authors suggest properly designed studies with mortality as the primary outcome is needed to further answer this question.
AHRQ-funded; HS025008.
Citation:
Pepper DJ, Sun J, Rhee C .
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
Chest 2019 Jun;155(6):1109-18. doi: 10.1016/j.chest.2018.12.029..
Keywords:
Antibiotics, Critical Care, Evidence-Based Practice, Medication, Mortality, Outcomes, Sepsis
Hartman ME, Saeed MJ, Bennett T
Readmission and late mortality after critical illness in childhood.
Researchers sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. They found that, in multivariate analysis, risk of nonelective readmission for children without cancer was higher with longer index ICU admission length of stay, younger age, and several chronic and acute conditions. Mortality in the year after ICU discharge was low overall.
AHRQ-funded; HS019455.
Citation:
Hartman ME, Saeed MJ, Bennett T .
Readmission and late mortality after critical illness in childhood.
Pediatr Crit Care Med 2017 Mar;18(3):e112-e21. doi: 10.1097/pcc.0000000000001062.
.
.
Keywords:
Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Mortality, Hospital Readmissions
Hakkarainen TW, Arbabi S, Willis MM
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
This study evaluated previously independent older patients discharged to skilled nursing facilities (SNFs) and identified risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. It found that a large proportion of older patients discharging to SNFs never return home.
AHRQ-funded; HS020025.
Citation:
Hakkarainen TW, Arbabi S, Willis MM .
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
Ann Surg 2016 Feb;263(2):280-5. doi: 10.1097/sla.0000000000001367..
Keywords:
Critical Care, Hospitalization, Risk, Elderly, Mortality
Nagendran M, Dimick JB, Gonzalez AA
Mortality among older adults before versus after hospital transition to intensivist staffing.
The researchers sought to determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. Adoption of an intensivist staffing model was not associated with improved mortality in Medicare beneficiaries. These findings suggest that the lower mortality rates previously observed at hospitals with intensivist staffing may be attributable to other factors.
AHRQ-funded; HS023621; HS024403.
Citation:
Nagendran M, Dimick JB, Gonzalez AA .
Mortality among older adults before versus after hospital transition to intensivist staffing.
Med Care 2016 Jan;54(1):67-73. doi: 10.1097/mlr.0000000000000446.
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Keywords:
Mortality, Elderly, Intensive Care Unit (ICU), Hospitalization, Critical Care
Ortiz JR, Neuzil KM, Cooke CR
The authors reply.
The authors respond to a letter about their AHRQ-funded study from van Someren Gréve et al on sharing interesting data from their pilot viral surveillance study in Dutch ICUs. They argue that laboratory testing should not delay treatment. Additional measures, such as vaccinating medical staff and implementing infection control procedures, are important to protect all hospitalized patients from the spread of influenza virus.
AHRQ-funded; HS020672.
Citation:
Ortiz JR, Neuzil KM, Cooke CR .
The authors reply.
Crit Care Med 2015 Apr;43(4):e118. doi: 10.1097/ccm.0000000000000887..
Keywords:
Influenza, Critical Care, Hospitalization, Mortality
Lanspa MJ, Dickerson J, Morris AH
Coefficient of glucose variation is independently associated with mortality in critically ill patients receiving intravenous insulin.
The researchers studied the association between coefficient of variation of glucose and mortality and also whether the association between glycemic variability and mortality was independent of hypoglycemia and other patient attributes. They found that blood glucose coefficient of variation was associated with 30-day mortality both in diabetic as well as in non-diabetic patients. The association was independent of hypoglycemia, blood glucose target, age, disease severity, and comorbidities.
AHRQ-funded; HS006594.
Citation:
Lanspa MJ, Dickerson J, Morris AH .
Coefficient of glucose variation is independently associated with mortality in critically ill patients receiving intravenous insulin.
Crit Care 2014 Apr 30;18(2):R86. doi: 10.1186/cc13851..
Keywords:
Critical Care, Mortality, Diabetes
Patel RB, Mathur MB, Gould M
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
The researchers for this international study sought to model individuals at highest risk of mortality from HPAI N5N1 virus infection in order to inform preventive and therapeutic interventions. They found that age, health expenditure, delay from symptom onset to hospitalization and country are significant predictors of mortality.
AHRQ-funded; HS019816
Citation:
Patel RB, Mathur MB, Gould M .
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
PLoS One. 2014 Mar 25;9(3):e91630. doi: 10.1371/journal.pone.0091630..
Keywords:
Influenza, Mortality, Critical Care, Hospitalization, Risk
Gabler NB, Ratcliffe SJ, Wagner J
Mortality among patients admitted to strained intensive care units.
A study of 264,401 patients admitted to 155 U.S. intensive care units (ICUs) found several factors associated with small increases in mortality: ICU census on the day of a patient’s admission, the presence of higher acuity patients, and the proportion of new admissions. These sources of ICU strain were associated with mortality increases particularly in ICUs employing closed staffing models.
AHRQ-funded; HS018406
Citation:
Gabler NB, Ratcliffe SJ, Wagner J .
Mortality among patients admitted to strained intensive care units.
Am J Respir Crit Care. 2013 Oct 1;188(7):800-6. doi: 10.1164/rccm.201304-0622OC..
Keywords:
Mortality, Intensive Care Unit (ICU), Critical Care, Patient Safety, Workforce