National Healthcare Quality and Disparities Report
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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
176 to 200 of 207 Research Studies DisplayedSnider C, Jiang D, Logsetty S
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
In Winnipeg, Canada, 20% of youth who visit an emergency department with an injury due to violence have a second visit for a subsequent violent injury within 1 year. This study protocol describes a wraparound care model delivered by a support worker with experience with violence, supported by social workers and links to multiple community partners. It has been developed using an integrated knowledge translation approach.
AHRQ-funded; HS016444.
Citation: Snider C, Jiang D, Logsetty S .
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
BMJ Open 2015 May 19;5(5):e008088. doi: 10.1136/bmjopen-2015-008088.
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Keywords: Children/Adolescents, Emergency Department, Injuries and Wounds
LaFleur J, Steenhoek CL, Horne J
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
The researchers compared 2 fracture absolute risk assessment (FARA) tools for use with electronic health records (EHRs) to determine which would more accurately identify patients known to be high risk for fracture. They found that absolute fracture risk estimation with the VA-FARA is more predictive of a first fracture than the WHO’s eFRAX in male veterans when used in an EHR-based population screening tool.
AHRQ-funded; HS018582.
Citation: LaFleur J, Steenhoek CL, Horne J .
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
Ann Pharmacother 2015 May;49(5):506-14. doi: 10.1177/1060028015572819..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Injuries and Wounds, Osteoporosis, Risk
Albrecht JS, Marcantonio ER, Roffey DM
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
This paper's objectives were to determine the stability of psychomotor subtypes of delirium over time and to identify characteristics associated with delirium psychomotor subtypes in individuals undergoing surgical repair of hip fracture. The Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair Cognitive Ancillary Study was conducted. Results showed that psychomotor subtypes of delirium often fluctuated from assessment to assessment, rather than representing fixed categories of delirium. Hypoactive delirium was the most common presentation of delirium but the least likely to be documented by healthcare providers.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Marcantonio ER, Roffey DM .
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
J Am Geriatr Soc 2015 May;63(5):970-6. doi: 10.1111/jgs.13334.
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Keywords: Adverse Events, Cardiovascular Conditions, Injuries and Wounds, Neurological Disorders, Surgery
Sharma G, Meena R, Goodwin JS
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
The researchers quantified the risk of burn injury associated with home oxygen use and examined the risk factors associated with the development of this injury. They found that the absolute risk of burn injury in patients prescribed oxygen therapy was 2.98 per 1000 patients compared with 1.69 per 1000 patients not prescribed oxygen during a 22-month period.
AHRQ-funded; HS020642; HS022134.
Citation: Sharma G, Meena R, Goodwin JS .
Burn injury associated with home oxygen use in patients with chronic obstructive pulmonary disease.
Mayo Clin Proc 2015 Apr;90(4):492-9. doi: 10.1016/j.mayocp.2014.12.024..
Keywords: Injuries and Wounds, Adverse Events, Risk, Respiratory Conditions, Elderly
Lewis SS, Dicks KV, Chen LF
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The researchers compared time to diagnosis of invasive surgical site infection (SSI) following hip vs knee arthroplasty. They found that time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume. They hypothesized that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis.
AHRQ-funded; HS023866.
Citation: Lewis SS, Dicks KV, Chen LF .
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
Clin Infect Dis 2015 Apr 1;60(7):990-6. doi: 10.1093/cid/ciu975.
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Keywords: Diagnostic Safety and Quality, Healthcare-Associated Infections (HAIs), Orthopedics, Surgery, Injuries and Wounds, Adverse Events
Sherry MK, Mossallam M, Mulligan M
Rates of intentionally caused and road crash deaths of US citizens abroad.
The researchers invetigated rates of death by cause and country among US travellers to aid in the development of risk reduction strategies. Using data from January 2003 to December 2009 from the US Department of State's Bureau of Consular Affairs and from the US Department of Commerce's Office of Travel and Tourism, they found that the leading cause of non-natural deaths in US travellers abroad was road crashes, which exceeds intentional injury as the leading cause of non-natural deaths in almost every country where US citizens travel.
AHRQ-funded; HS000029.
Citation: Sherry MK, Mossallam M, Mulligan M .
Rates of intentionally caused and road crash deaths of US citizens abroad.
Inj Prev 2015 Apr;21(e1):e10-4. doi: 10.1136/injuryprev-2013-040923.
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Keywords: Injuries and Wounds, Mortality, Risk, Trauma
Balachandra S, Pardos de la Gandara M, Salvato S
Recurrent furunculosis caused by a community-acquired Staphylococcus aureus strain belonging to the USA300 clone.
This study is a clinical history of a patient with recurrent skin infections caused by a strain of CA-MRSA belonging to the USA300 clone. The strain was recovered repeatedly from wounds and lower body sites but never from the nostrils. The clinical history of recurrence strongly suggests the existence of a common environmental source of the MRSA strain.
AHRQ-funded; HS021667.
Citation: Balachandra S, Pardos de la Gandara M, Salvato S .
Recurrent furunculosis caused by a community-acquired Staphylococcus aureus strain belonging to the USA300 clone.
Microb Drug Resist 2015 Apr;21(2):237-43. doi: 10.1089/mdr.2014.0283..
Keywords: Skin Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Community-Acquired Infections
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
Olsen MA, Nickel KB, Wallace AE
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
The researchers investigated whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. After analyzing a total of 119,973 hernia repair procedures, they found that the incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction necrosis.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Wallace AE .
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
Infect Control Hosp Epidemiol 2015 Mar;36(3):329-35. doi: 10.1017/ice.2014.44..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk, Patient Safety
Merkow RP, Ju MH, Chung JW
Underlying reasons associated with hospital readmission following surgery in the United States.
The objectives of this study were to characterize the reasons for and timing of readmissions and to examine factors associated with unplanned surgical readmissions. It found that readmissions after surgery were mostly associated with postdischarge complications related to the procedure and not with exacerbation of prior index admission complications.
AHRQ-funded; HS21857.
Citation: Merkow RP, Ju MH, Chung JW .
Underlying reasons associated with hospital readmission following surgery in the United States.
JAMA 2015 Feb 3;313(5):483-95. doi: 10.1001/jama.2014.18614..
Keywords: Surgery, Hospital Readmissions, Injuries and Wounds
Unni S, Yao Y, Milne N
An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database.
The researchers sought to identify variables in an EMR database for calculating fracture risk Assessment (FRAX) score in a cohort of postmenopausal women, to estimate absolute fracture risk. They found that mean 10-year risk for any major fracture was 11.1 percent when bone mineral density (BMD) was used and 11.2 percent when BMI was used.
AHRQ-funded; HS0018582.
Citation: Unni S, Yao Y, Milne N .
An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database.
Osteoporos Int 2015 Feb;26(2):581-7. doi: 10.1007/s00198-014-2899-7..
Keywords: Electronic Health Records (EHRs), Injuries and Wounds, Risk, Osteoporosis, Health Information Technology (HIT)
Kastenberg ZJ, Hurley MP, Weiser TG
Adding insult to injury: discontinuous insurance following spine trauma.
The researchers evaluated patterns of discontinuation of initial insurance coverage for patients who undergo surgery for traumatic spine injury with and without spinal cord injury and compare these patterns with those for matched control subjects. They found a twofold increased risk of insurance discontinuation for patients with traumatic spine injury without spinal cord injury and a nearly threefold increased risk for patients with spinal cord injury.
AHRQ-Funded; HS000028.
Citation: Kastenberg ZJ, Hurley MP, Weiser TG .
Adding insult to injury: discontinuous insurance following spine trauma.
J Bone Joint Surg Am 2015 Jan 21;97(2):141-6. doi: 10.2106/jbjs.n.00148..
Keywords: Injuries and Wounds, Health Insurance, Trauma
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Crandall CJ, Newberry SJ, Diamant A
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
This article updates a 2007 evidence review focusing on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density. It concludes that good quality evidence supports that several medications for bone density in osteoporotic range and/or pre-existing hip or vertebral fracture reduce fracture risk.
AHRQ-funded; 290200710062I
Citation: Crandall CJ, Newberry SJ, Diamant A .
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
Ann Intern Med. 2014 Nov 18;161(10):711-23. doi: 10.7326/M14-0317..
Keywords: Comparative Effectiveness, Medication, Injuries and Wounds
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Bish EK, El-Amine H, Steighner LA
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
The researchers sought to identify the risk factors associated with surgical site infections (SSIs) resulting from procedures performed at ambulatory surgery centers (ASCs) and to design an intervention to mitigate the likelihood of SSIs for the most common risk factors that were identified by the socio-technical probabilistic risk assessment (ST-PRA) tool for a particular surgical procedure. They found that failure to protect the patient effectively accounted for 51.9% of SSIs in the ambulatory care setting. Critical components of this event included skin preparation, antibiotic administration, staff training, proper response to glove punctures during surgery, and adherence to surgical preparation rules related to the wearing of jewelry, watches, and artificial nails. They determined that, assuming a 75% reduction in noncompliance on any combination of 2 of these 5 components, the risk for an SSI decreased.
AHRQ-funded; 290200600019I.
Citation: Bish EK, El-Amine H, Steighner LA .
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S133-41. doi: 10.1086/677824.
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Keywords: Ambulatory Care and Surgery, Risk, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Safford MM, Barasch A, Curtis JR
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
This study examined associations between bisphosphonate use and nontraumatic subtrochanteric (NTST) femoral fractures and hip fractures in the Veterans Health Administration. It found that nontraumatic subtrochanteric femoral fractures were uncommon, and longer bisphosphonate use was associated with lower (not higher) risk. In men, risks of NTST femoral fractures associated with bisphosphonate treatment may be low in contrast to substantial protective benefits for hip fracture.
AHRQ-funded; HS016956; HS018517.
Citation: Safford MM, Barasch A, Curtis JR .
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
J Clin Rheumatol 2014 Oct;20(7):357-62. doi: 10.1097/rhu.0000000000000170..
Keywords: Elderly, Injuries and Wounds, Risk, Medication, Adverse Events
Warren DK, Nickel KB, Wallace AE
Can additional information be obtained from claims data to support surgical site infection diagnosis codes?
The authors sought to confirm a claims algorithm to identify surgical site infections (SSIs) by examining the presence of clinically expected SSI treatment. They found that over 94% of patients identified by their claims algorithm as having an SSI received clinically expected treatment for infection, including antibiotics, surgical treatment, and culture, suggesting that this algorithm has very good positive predictive value. They concluded that their method may facilitate retrospective SSI surveillance and comparison of SSI rates across facilities and providers.
AHRQ-funded; HS019713.
Citation: Warren DK, Nickel KB, Wallace AE .
Can additional information be obtained from claims data to support surgical site infection diagnosis codes?
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S124-32. doi: 10.1086/677830.
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Keywords: Data, Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Injuries and Wounds, Adverse Events
Curtin CM, Hernandez-Boussard T
Readmissions after treatment of distal radius fractures.
The authors assessed the rates and associated diagnoses of readmissions for patients having received an intervention for treatment of distal radius fracture. Using AHRQ data sets, they found that many distal radius fracture patients return to the health care system for pain-related issues, and they recommended implementation of better pain management.
AHRQ-funded; HS018558.
Citation: Curtin CM, Hernandez-Boussard T .
Readmissions after treatment of distal radius fractures.
J Hand Surg Am 2014 Oct;39(10):1926-32. doi: 10.1016/j.jhsa.2014.07.041.
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Keywords: Injuries and Wounds, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Pain, Hospital Readmissions
Agos F, Shoda C, Bransford D
Part II: managing perioperative hyperglycemia in total hip and knee replacement surgeries.
Perioperative hyperglycemia management is an important factor in reducing the risk of surgical site infections (SSIs) in all patients whether they have diabetes or not. This article describes the impact of an evidence-based practice standard for perioperative hyperglycemia management in the reduction of SSIs in patients having total hip and knee replacement surgery.
AHRQ-funded; HS017892
Citation: Agos F, Shoda C, Bransford D .
Part II: managing perioperative hyperglycemia in total hip and knee replacement surgeries.
Nurs Clin North Am. 2014 Sep;49(3):299-308. doi: 10.1016/j.cnur.2014.05.004..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Orthopedics, Injuries and Wounds
Brown JR, Solomon RJ, Sarnak MJ
Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.
The researchers sought to determine whether a 6-year regional multicenter quality improvement intervention could reduce contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary interventions. They found that benchmark hospitals had no significant changes in CI-AKI, while rates of CI-AKI were significantly reduced in hospitals receiving the intervention. Key qualitative system factors associated with improvement included multidisciplinary teams, limiting contrast volume, standardized fluid orders, intravenous fluid bolus, and patient education about oral hydration.
AHRQ-funded; HS018443.
Citation: Brown JR, Solomon RJ, Sarnak MJ .
Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.
Circ Cardiovasc Qual Outcomes 2014 Sep;7(5):693-700. doi: 10.1161/circoutcomes.114.000903.
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Keywords: Adverse Drug Events (ADE), Injuries and Wounds, Patient Safety, Heart Disease and Health, Quality Improvement
Foster NA, Elfenbein DM, Kelley W, Jr.
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
The investigators aimed to determine whether ground transport (GT) for interfacility transfer of patients with spinal injury resulted in less favorable clinical outcomes compared with helicopter aeromedical transport systems (HEMS). They found that GT for interfacility transfer of patients with spinal injury appears to be safe and suitable for patients who lack other compelling reasons for HEMS.
AHRQ-funded; HS000032.
Citation: Foster NA, Elfenbein DM, Kelley W, Jr. .
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
Spine J 2014 Jul;14(7):1147-54. doi: 10.1016/j.spinee.2013.07.478.
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Keywords: Emergency Medical Services (EMS), Transitions of Care, Injuries and Wounds
Cleveland N, Colwell C, Douglass E
Motor vehicle crash severity estimations by physicians and prehospital personnel.
The purpose of this study was to determine whether emergency physicians (EPs) and EMS personnel differ in their assessment of motor vehicle collision severity and the potential for serious injury when viewing crash scene photographs. They found excellent crash and injury agreement at both ends of the severity spectrum but only modest agreement, and therefore greater variability, in the middle of the severity spectrum.
AHRQ-funded; HS017526
Citation: Cleveland N, Colwell C, Douglass E .
Motor vehicle crash severity estimations by physicians and prehospital personnel.
Prehosp Emerg Care. 2014 Jul-Sep;18(3):402-7. doi: 10.3109/10903127.2014.891065..
Keywords: Emergency Medical Services (EMS), Trauma, Injuries and Wounds, Provider: Health Personnel, Diagnostic Safety and Quality
Daniels AH, Daiello LA, Lareau CR
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
The authors conducted a study to evaluate the prevalence of cognitive impairment (CI) compared with normal cognition (NC) in elderly hip fracture patients 65 years and older. Results showed many patients had unrecognized CI before surgery and had significantly more pain and fear than the NC group.
AHRQ-funded; HS017735
Citation: Daniels AH, Daiello LA, Lareau CR .
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
Ame J Orthop. 2014 Jul; 43(7):E146-52..
Keywords: Elderly, Injuries and Wounds, Neurological Disorders, Surgery