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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 7 of 7 Research Studies Displayed
Andrews PS, Wang S, Perkins AJ
Relationship between intensive care unit delirium severity and 2-year mortality and health care utilization.
Critical care patients with delirium are at an increased risk of functional decline and mortality long term. The objective of this study was to determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge. The investigators concluded that increased delirium severity and days of delirium or coma were associated with higher mortality risk 2 years after discharge.
AHRQ-funded; P30 HS024384.
Citation: Andrews PS, Wang S, Perkins AJ . Relationship between intensive care unit delirium severity and 2-year mortality and health care utilization. Am J Crit Care 2020 Jul 1;29(4):311-17. doi: 10.4037/ajcc2020498..
Keywords: Intensive Care Unit (ICU), Neurological Disorders, Mortality, Risk
Crystal S, Jarrín OF, Rosenthal M
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
This study examines the success of the national partnership campaign to reduce prescription of antipsychotic medications to elderly nursing home residents with dementia. Antipsychotic medications have been shown to increase mortality. Use of these medications had increased 23.9% in dementia patients by 2011. The campaign reduced use by 40.1% to 14.3% by the second quarter of 2019. The campaign measured progress with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. Sedative-hypnotic medication use also decreased in tandem with antipsychotic reduction suggesting that the campaign increased attention to the use of other risky psychotropic medications.
AHRQ-funded; HS023464; HS022406; HS023258; HS021112.
Citation: Crystal S, Jarrín OF, Rosenthal M . National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes. Innov Aging 2020 Jun 2;4(3):igaa018. doi: 10.1093/geroni/igaa018..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Quality Improvement, Quality of Care, Medication, 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.
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
Schiltz NK, Warner DF, Sun J
The influence of multimorbidity on leading causes of death in older adults with cognitive impairment.
The aim of this study was to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. The authors found that multimorbidity was common in the study population. Heart disease was the leading cause in all groups, but with a larger percentage of deaths in the mild and moderate/severe cognitively impaired groups than among the noncognitively impaired. The different "paths" down the regression trees showed that the distribution of causes of death changed with different combinations of multimorbidity.
Citation: Schiltz NK, Warner DF, Sun J . The influence of multimorbidity on leading causes of death in older adults with cognitive impairment. J Aging Health 2019 Jul;31(6):1025-42. doi: 10.1177/0898264317751946..
Keywords: Elderly, Dementia, Neurological Disorders, Chronic Conditions, Mortality
Armstrong MJ, Alliance S, Corsentino P
Cause of death and end-of-life experiences in individuals with dementia with Lewy bodies.
Researchers investigate the natural history, cause of death, and end-of-life experiences of individuals diagnosed with dementia with Lewy bodies (DLB). In the 20-question survey, respondents indicated that physicians rarely discussed what to expect at the end of life and that the caregiver usually initiated such conversations. Failure to thrive was the most common cause of death, followed by pneumonia and swallowing difficulties, other medical conditions, and complications from falling. The researchers conclude that the study results highlight a critical need for better prognostic counseling and education for persons and families living with DLB, and they recommended further study.
Citation: Armstrong MJ, Alliance S, Corsentino P . Cause of death and end-of-life experiences in individuals with dementia with Lewy bodies. J Am Geriatr Soc 2019 Jan;67(1):67-73. doi: 10.1111/jgs.15608..
Keywords: Dementia, Neurological Disorders, Patient Experience, Palliative Care, Mortality, Elderly
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM . Long-term reduction of health care costs and utilization after epilepsy surgery. Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Kaiboriboon K, Schiltz NK, Bakaki PM
Premature mortality in poor health and low income adults with epilepsy.
This research study’s objective was to examine mortality and causes of death in socioeconomically disadvantaged persons with epilepsy in the United States. While death from epilepsy-related causes was about 10%, comorbidities like cardiovascular disease, cancer, and unintentional injuries caused 18.4% of deaths. Socioeconomically deprived and Medicaid-insured patients died 17 years prematurely.
Epilepsia. 2014 Nov;55(11):1781-8. doi: 10.1111/epi.12789.
Citation: Kaiboriboon K, Schiltz NK, Bakaki PM . Premature mortality in poor health and low income adults with epilepsy. .
Keywords: Low-Income, Mortality, Neurological Disorders, Social Determinants of Health