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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 14 of 14 Research Studies DisplayedAlrawashdeh M, Klompas M, Kimmel S
Epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals.
This study examined the epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals from January 2009 to September 2015. This retrospective cohort study looked at about 373 hospitals with a total of 6,715,286 hospitalizations. Using ICD-9 CM codes, 5.6% had sepsis, 1.9% had opioid-related hospitalizations, and 0.1% had both. Patients hospitalized with both diagnoses were younger and healthier, had more bloodstream infections from Gram-positive and fungal pathogens, and had lower in-hospital mortality rates. Of 1,803 patients with opioid-related hospitalizations who died in-hospital, 51.5% had sepsis. From 2009 to 2015, the proportion of sepsis hospitalizations that were opioid-related increased by 77%.
AHRQ-funded; HS025008.
Citation: Alrawashdeh M, Klompas M, Kimmel S .
Epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals.
Crit Care Med 2021 Dec;49(12):2102-11. doi: 10.1097/ccm.0000000000005141..
Keywords: Sepsis, Opioids, Hospitalization
Masonbrink AR, Harris M, Hall M
Safety events in children's hospitals during the COVID-19 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. The objective of this study was to compare pediatric hospitalization safety events during the pandemic versus previous years. The investigators concluded that postoperative sepsis rates increased among children hospitalized during COVID-19. They suggest that efforts are needed to improve safety of postoperative care for hospitalized children.
AHRQ-funded; HS024554; HS024592.
Citation: Masonbrink AR, Harris M, Hall M .
Safety events in children's hospitals during the COVID-19 pandemic.
Hosp Pediatr 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937..
Keywords: Children/Adolescents, COVID-19, Patient Safety, Sepsis, Adverse Events, Hospitalization, Hospitals, Inpatient Care, Infectious Diseases, Public Health
Kuye I, Anand V, Klompas M
Prevalence and clinical characteristics of patients with sepsis discharge diagnosis codes and short lengths of stay in U.S. hospitals.
The authors investigated the prevalence and clinical characteristics of patients diagnosed with sepsis in order to provide insight into how sepsis diagnoses are being applied as well as the breadth of illnesses encompassed by current sepsis definitions. In their study, they found that one in 10 patients who coded for sepsis were discharged alive within 3 days. Although most short-stay patients met systemic inflammatory response syndrome criteria, they met Sepsis-3 criteria less than half the time. These findings underscore the incomplete uptake of Sepsis-3 definitions, the breadth of illness severities encompassed by both traditional and new sepsis definitions, and the possibility that some patients with sepsis recover very rapidly.
AHRQ-funded; HS025008.
Citation: Kuye I, Anand V, Klompas M .
Prevalence and clinical characteristics of patients with sepsis discharge diagnosis codes and short lengths of stay in U.S. hospitals.
Crit Care Explor 2021 Mar;3(3):e0373. doi: 10.1097/cce.0000000000000373..
Keywords: Sepsis, Hospitalization
Bourne DS, Davis BS, Gigli KH
Economic analysis of mandated protocolized sepsis care in New York hospitals.
Investigators evaluated the effects of the 2013 New York State sepsis regulations on the costs of care for patients hospitalized with sepsis. They found that mandated protocolized sepsis care was not associated with significant changes in hospital costs in patients hospitalized with sepsis in New York State.
AHRQ-funded; HS025146.
Citation: Bourne DS, Davis BS, Gigli KH .
Economic analysis of mandated protocolized sepsis care in New York hospitals.
Crit Care Med 2020 Oct;48(10):1411-18. doi: 10.1097/ccm.0000000000004514..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sepsis, Healthcare Costs, Hospitalization, Hospitals
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
Cooper AJ, Keller SP, Chan C
Improvements in sepsis-associated mortality in hospitalized patients with cancer versus those without cancer. a 12-year analysis using clinical data.
The goal of this study was to assess trends in sepsis-associated mortality in hospitalized patients with and without cancer using objective clinical criteria to identify sepsis and detailed clinical data to adjust for severity of illness. Findings showed that sepsis-associated mortality rates declined significantly over a 12-year period in patients with cancer, but not in patients without cancer. Potential explanations include advances in the management of cancer and/or better sepsis treatments specifically in patients with cancer.
AHRQ-funded; HS025008.
Citation: Cooper AJ, Keller SP, Chan C .
Improvements in sepsis-associated mortality in hospitalized patients with cancer versus those without cancer. a 12-year analysis using clinical data.
Ann Am Thorac Soc 2020 Apr;17(4):466-73. doi: 10.1513/AnnalsATS.201909-655OC..
Keywords: Sepsis, Mortality, Cancer, Hospitalization, Outcomes
Goldstein E, Olesen SW, Karaca Z
AHRQ Author: Karaca Z
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
The authors related state-specific rates of outpatient prescribing overall for oral fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011 and 2012 to state-specific rates of septicemia hospitalization in several age groups of adults. They found positive associations between the rates of prescribing for penicillins and the rates of hospitalization with septicemia in US adults aged 50-84 years and recommended further studies.
AHRQ-authored.
Citation: Goldstein E, Olesen SW, Karaca Z .
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
BMC Public Health 2019 Aug 19;19(1):1138. doi: 10.1186/s12889-019-7431-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Antibiotics, Antimicrobial Stewardship, Sepsis, Medication, Hospitalization
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Goldstein E, MacFadden DR, Karaca Z
AHRQ Author: Karaca Z Steiner CA
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Researchers studied the relation between the prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. They found that, among the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50 years, and with sepsis mortality rates for individuals aged 18-84 years. They also found a number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults.
AHRQ-authored.
Citation: Goldstein E, MacFadden DR, Karaca Z .
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Int J Antimicrob Agents 2019 Jul;54(1):23-34. doi: 10.1016/j.ijantimicag.2019.03.004..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospitalization, Medication, Mortality, Sepsis
Sudduth CL, Overton EC, Lyu PF
Filtering authentic sepsis arising in the ICU using administrative codes coupled to a SIRS screening protocol.
Using administrative codes and minimal physiologic and laboratory data, researchers sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. They concluded that selected administrative codes coupled to SIRS criteria and applied to patients admitted to ICU can yield up to 94 percent authentic sepsis patients. However, only 1/3 of patients thus identified appeared to become septic during their ICU stay.
AHRQ-funded; HS000055.
Citation: Sudduth CL, Overton EC, Lyu PF .
Filtering authentic sepsis arising in the ICU using administrative codes coupled to a SIRS screening protocol.
J Crit Care 2017 Jun;39:220-24. doi: 10.1016/j.jcrc.2017.01.012.
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Keywords: Diagnostic Safety and Quality, Intensive Care Unit (ICU), Hospitalization, Sepsis
Bhattacharjee P, Edelson DP, Churpek MM
Identifying patients with sepsis on the hospital wards.
The goal of this review was to discuss recent advances in the detection of sepsis in patients on the hospital wards. The investigators discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening patients with sepsis, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick sepsis-related organ failure assessment (qSOFA) score.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Edelson DP, Churpek MM .
Identifying patients with sepsis on the hospital wards.
Chest 2017 Apr;151(4):898-907. doi: 10.1016/j.chest.2016.06.020..
Keywords: Clinical Decision Support (CDS), Diagnostic Safety and Quality, Hospitalization, Sepsis
Banerjee T, Meyer TW, Shafi T
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
P-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. The researchers explored the relationship between free and total PCS and indoxyl sulfate (IS) with infection-related hospitalizations (IH) and septicemia in 2 cohorts. Their results suggest an association between higher concentrations of free PCS and infection-related and sepsis-related hospitalizations in hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Banerjee T, Meyer TW, Shafi T .
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
Medicine 2017 Feb;96(6):e5799. doi: 10.1097/md.0000000000005799.
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Keywords: Hospitalization, Kidney Disease and Health, Kidney Disease and Health, Digestive Disease and Health, Sepsis
Donnelly JP, Locke JE, MacLennan PA
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
The researchers investigated the impact of solid organ transplant (SOT) on outcomes following sepsis. They found that among patients hospitalized for severe sepsis or sepsis, those with SOT had lower inpatient mortality than those without SOT.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Locke JE, MacLennan PA .
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
Clin Infect Dis 2016 Jul 15;63(2):186-94. doi: 10.1093/cid/ciw295.
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Keywords: Transplantation, Mortality, Sepsis, Hospitalization, Patient-Centered Outcomes Research
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis