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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 8 of 8 Research Studies Displayed
Hay CC, Graham JE, Pappadis MR
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
The goal of this retrospective observational study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. Subjects were Medicare fee-for-service beneficiaries discharged from inpatient rehabilitation facilities after a stroke. Results showed that when sociodemographic and clinical factors were controlled, females were more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who lived alone before their stroke had higher odds of discharging at a supervision level or better.
Citation: Hay CC, Graham JE, Pappadis MR . The impact of one's sex and social living situation on rehabilitation outcomes after a stroke. Am J Phys Med Rehabil 2020 Jan;99(1):48-55. doi: 10.1097/phm.0000000000001276..
Keywords: Stroke, Rehabilitation, Elderly, Patient-Centered Outcomes Research, Sex Factors, Cardiovascular Conditions, Outcomes
Adediran T, Drumheller BC, McCunn M
Sex differences in in-hospital complications among older adults after traumatic brain injury.
This study examined sex differences in in-hospital complications among older adults after traumatic brain injury (TBI). Previous evidence has suggested that women have better outcomes than men after TBI. A retrospective cohort study was conducted of adults aged 65 years and older treated for moderate to severe TBI at R. Adams Cowley Shock Trauma Center from 1996 to 2012. The investigators identified TBI using ICD-9 CM codes and inclusion in the study required an abbreviated injury scale head score of 3 or greater, abbreviated injury scale scores for other body regions of 2 or greater, and a blunt injury mechanism. Out of 2511 patients, 51.1% were men, and 25.1% developed an in-hospital complication. Men had a complication rate of 28.1% versus 22.0% for women.
Citation: Adediran T, Drumheller BC, McCunn M . Sex differences in in-hospital complications among older adults after traumatic brain injury. J Surg Res 2019 Nov;243:427-33. doi: 10.1016/j.jss.2019.05.053..
Keywords: Elderly, Sex Factors, Adverse Events, Hospitalization, Brain Injury
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M . Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients. Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Dialysis, Disparities, Elderly, Outcomes, Patient-Centered Outcomes Research, Sex Factors, Surgery
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
Citation: Angraal S, Khera R, Wang Y . Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014. J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial / Ethnic Minorities, Sex Factors
Albright KC, Howard VJ, Howard G
Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study.
This study analyzed discharge medications for participants hospitalized for an ischemic stroke during follow-up of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. It found that statin discharge prescribing may differ among Stroke Belt and non-Stroke Belt residents, particularly in older Americans and men.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Howard VJ, Howard G . Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study. J Am Heart Assoc 2017 Aug 2;6(8). doi: 10.1161/jaha.117.005523.
Keywords: Disparities, Medication, Stroke, Elderly, Sex Factors
Palamaner Subash Shantha G, Bhave PD, Girotra S
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
This study assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. It concluded that the reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
Citation: Palamaner Subash Shantha G, Bhave PD, Girotra S . Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation. Circ Cardiovasc Qual Outcomes 2017 Apr;10(4). doi: 10.1161/circoutcomes.116.003418.
Keywords: Elderly, Heart Disease and Health, Blood Thinners, Medication, Comparative Effectiveness, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Evidence-Based Practice
Albrecht JS, McCunn M, Stein DM
Sex differences in mortality following isolated traumatic brain injury among older adults.
This retrospective cohort study's objective was to determine the possibility of sex differences in mortality among older adutls following isolated traumatic brain injury (TBI) and to comapre with findings using all TBI. The researchers did not find that women were significantly associated with decreased odds of mortality following isolated TBI.
Citation: Albrecht JS, McCunn M, Stein DM . Sex differences in mortality following isolated traumatic brain injury among older adults. J Trauma Acute Care Surg 2016 Sep;81(3):486-92. doi: 10.1097/ta.0000000000001118.
Keywords: Sex Factors, Trauma, Brain Injury, Mortality, Elderly
Just E, Casarett DJ, Asch DA
Differences in terminal hospitalization care between U.S. men and women.
The authors sought to determine whether men and women receive different care during terminal hospitalizations by examining sex-based differences in lengths of stay, resuscitation status, and intensive interventions and processes of care. They found that. compared with men, women had slightly shorter hospitalizations and were more likely to have a do-not-resuscitate order. Women remained less likely to receive care in an intensive care unit, cardiopulmonary resuscitation, mechanical ventilation, hemodialysis, or surgical procedures. The researchers concluded that men who die in hospitals receive more aggressive care than women.
Citation: Just E, Casarett DJ, Asch DA . Differences in terminal hospitalization care between U.S. men and women. J Pain Symptom Manage 2016 Aug;52(2):205-11. doi: 10.1016/j.jpainsymman.2016.01.013.
Keywords: Disparities, Palliative Care, Hospitalization, Sex Factors, Elderly