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
1 to 25 of 61 Research Studies DisplayedPruitt SL, Tiro JA, Xuan L
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
The researchers tested the Hispanic and Immigrant Paradoxes-i.e., survival advantages despite a worse risk factor profile-and the modifying role of neighborhood context. They found no evidence of an Immigrant Paradox and some evidence of a Hispanic Paradox where protective effects were limited to U.S.-born Hispanics. Contrary to prior studies, foreign birthplace and residence in higher Hispanic density neighborhoods were associated with increased mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Tiro JA, Xuan L .
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
Int J Environ Res Public Health 2016 Dec 14;13(12):E1238. doi: 10.3390/ijerph13121238.
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Keywords: Cancer: Breast Cancer, Low-Income, Racial and Ethnic Minorities, Mortality, Racial and Ethnic Minorities
Salinas JL, Rentsch C, Marconi VC
Baseline, time-updated, and cumulative HIV care metrics for predicting acute myocardial infarction and all-cause mortality.
The researchers studied prediction rates of myocardial infarction in those with HIV. They found that the Veterans Aging Cohort Study (VACS) Index provided better acute myocardial infarction and mortality prediction than CD4 count and HIV-1 RNA, concluding that current health determines risk more accurately than prior history.
AHRQ-funded; HS018372.
Citation: Salinas JL, Rentsch C, Marconi VC .
Baseline, time-updated, and cumulative HIV care metrics for predicting acute myocardial infarction and all-cause mortality.
Clin Infect Dis 2016 Dec 1;63(11):1423-30. doi: 10.1093/cid/ciw564.
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Keywords: Human Immunodeficiency Virus (HIV), Mortality, Heart Disease and Health, Risk
Brown JR, Rezaee ME, Marshall EJ
Hospital mortality in the United States following acute kidney injury.
This review discusses the epidemiology of acute kidney injury (AKI) and its association with in-hospital mortality in the United States. Also discussed is the importance of the 71 percent reduction in AKI-related mortality among hospitalized patients in the United States and whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Marshall EJ .
Hospital mortality in the United States following acute kidney injury.
Biomed Res Int 2016;2016:4278579. doi: 10.1155/2016/4278579.
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Keywords: Mortality, Hospitalization, Adverse Events, Patient Safety
Yakoob MY, Micha R, Khatibzadeh S
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
This article's objective is to quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. The authors used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. They found suboptimal diet to be the leading cuase of cardiometabolic mortality in 4 of 5 countries. They concluded that important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.
AHRQ-funded; HS000062.
Citation: Yakoob MY, Micha R, Khatibzadeh S .
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
Am J Public Health 2016 Dec;106(12):2113-25. doi: 10.2105/ajph.2016.303368.
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Keywords: Cardiovascular Conditions, Diabetes, Mortality, Risk
Metz TD, Rovner P, Hoffman MC
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
This study ascertained demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) and to identify opportunities for prevention. It found that in seventeen percent (n=10) of maternal deaths there had been a known substance use disorder. Prior psychiatric diagnoses were documented in 54 percent (n=32) and prior suicide attempts in 10 percent (n=6).
AHRQ-funded; HS022143.
Citation: Metz TD, Rovner P, Hoffman MC .
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
Obstet Gynecol 2016 Dec;128(6):1233-40. doi: 10.1097/aog.0000000000001695.
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Keywords: Behavioral Health, Pregnancy, Prevention, Maternal Care, Mortality
Brown JR, Rezaee ME, Hisey WM
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
The researchers describe the epidemiology of dialysis-requiring acute kidney injury (AKI-D) as well as associated in-hospital mortality in the US. They found that the incidence rate of AKI-D has increased considerably in the US since 2001. However, in-hospital mortality associated with AKI-D hospital admissions has decreased significantly. AHRQ-funded; HS018443.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Hisey WM .
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
Am J Nephrol 2016;43(4):261-70. doi: 10.1159/000445846.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Kidney Disease and Health
Rosenberg AS, Ruthazer R, Paulus JK
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking. This study found that age at diagnosis, elevated creatinine, and white race were associated with inferior survival in patients with PTLD-MM.
AHRQ-funded; HS000060.
Citation: Rosenberg AS, Ruthazer R, Paulus JK .
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):684-92.e3. doi: 10.1016/j.clml.2016.09.002.
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Keywords: Adverse Events, Cancer, Mortality, Transplantation, Outcomes
Dimou FM, Mehta HB, Adhikari D
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
The authors' objective was to determine the use of extended criteria donors (ECD) in patients with nonalcoholic steatohepatitis undergoing liver transplantation to stimulate a liver-specific predictive model for ECD use. They found that ECDs in nonalcoholic steatohepatitis were associated with similar overall survival but increased risk of graft failure. The authors concluded that creation of an easily calculated, liver-specific model similar to the Kidney Donor Profile Index may help risk stratify patients and improve organ allocation.
AHRQ-funded; HS022134.
Citation: Dimou FM, Mehta HB, Adhikari D .
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
Surgery 2016 Dec;160(6):1533-43. doi: 10.1016/j.surg.2016.06.051.
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Keywords: Transplantation, Patient-Centered Outcomes Research, Risk, Mortality, Outcomes
Lee T, Thamer M, Zhang Y
Association of peritonitis with hemodialysis catheter dependence after modality switch.
This study characterized vascular access use after switch to hemodialysis and its effect on patient mortality. The researchers found that patients using a permanent vascular access 180 days after switching from peritoneal dialysis to hemodialysis had better adjusted survival during the ensuing year than those using a catheter. They concluded that among patients who switch, prior peritonitis is associated with a higher rate of persistent hemodialysis catheter use, which, in turn, is associated with lower patient survival.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Thamer M, Zhang Y .
Association of peritonitis with hemodialysis catheter dependence after modality switch.
Clin J Am Soc Nephrol 2016 Nov 7;11(11):1999-2004. doi: 10.2215/cjn.04970516.
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Keywords: Dialysis, Kidney Disease and Health, Evidence-Based Practice, Mortality, Patient-Centered Healthcare
Durstenfeld MS, Ogedegbe O, Katz SD
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. It examined outcomes after heart failure hospitalization within a large municipal health system and determined that racial and ethnic differences in outcomes were present.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Ogedegbe O, Katz SD .
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
JACC Heart Fail 2016 Nov;4(11):885-93. doi: 10.1016/j.jchf.2016.05.008.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitalization, Mortality, Outcomes, Racial and Ethnic Minorities
Gaither JR, Goulet JL, Becker WC
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
The objective of this study was to determine whether the presence of a substance use disorder (SUD) modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving long-term opioid therapy (LtOT) for pain. It found that for clinicians prescribing LtOT to patients with untreated SUDs, engaging patients with psychotherapeutic and SUD treatment services may reduce mortality.
AHRQ-funded; U19 HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The effect of substance use disorders on the association between guideline-concordant long-term opioid therapy and all-cause mortality.
J Addict Med 2016 Nov/Dec;10(6):418-28. doi: 10.1097/adm.0000000000000255.
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Keywords: Care Management, Medication, Mortality, Substance Abuse, Opioids, Patient-Centered Outcomes Research
Huo J, Lairson DR, Du XL
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
This study investigated the influence of hospital case volume on malignant melanoma survival and treatment utilization. The researchers discovered that for patients diagnosed with metastatic melanoma, being treated in a high-volume hospital was associated with an improvement in survival and lower utilization of chemotherapy, immunotherapy, surgery, and radiation therapy.
AHRQ-funded; HS018956.
Citation: Huo J, Lairson DR, Du XL .
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
Am J Clin Oncol 2016 Oct;39(5):491-6. doi: 10.1097/coc.0000000000000074.
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Keywords: Elderly, Hospitals, Mortality, Patient-Centered Outcomes Research, Cancer: Skin Cancer
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.
AHRQ-funded; HS024560.
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.
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Keywords: Sex Factors, Trauma, Brain Injury, Mortality, Elderly
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Wong SL, Revels SL, Yin H
Variation in hospital mortality rates with inpatient cancer surgery.
The purpose of this national study was to elucidate clinical mechanisms underlying variation in hospital mortality with major cancer surgery. It found that case-fatality rates among patients with complications at high-mortality hospitals were approximately twice as high as at low-mortality hospitals. This study implicates failure to rescue as the major reason for differences in hospital mortality rates with major cancer surgery.
AHRQ-funded; HS020937.
Citation: Wong SL, Revels SL, Yin H .
Variation in hospital mortality rates with inpatient cancer surgery.
Ann Surg 2015 Apr;261(4):632-6. doi: 10.1097/sla.0000000000000690..
Keywords: Mortality, Surgery, Cancer, Patient Safety, Quality of Care
Mukherjee JT, Beshansky JR, Ruthazer R
In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial.
The relationships between reduced left ventricular ejection fraction (LVEF) measured during index acute coronary syndrome (ACS) hospitalization and mortality and heart failure (HF) within 1 year are not well-defined. The researchers performed a retrospective analysis of 445 patients who had LVEF measured by left ventriculography or echocardiogram during hospitalization. They found that among patients with ACS, lower in-hospital LVEF is associated with increased 1-year mortality or hospitalization for HF.
AHRQ-funded; HS000060.
Citation: Mukherjee JT, Beshansky JR, Ruthazer R .
In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial.
Cardiovasc Ultrasound 2016 Aug 3;14(1):29. doi: 10.1186/s12947-016-0068-1.
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Keywords: Cardiovascular Conditions, Care Management, Heart Disease and Health, Mortality, Outcomes
Healy MA, Grenda TR, Suwanabol PA
Colon cancer operations at high- and low-mortality hospitals.
The authors sought to evaluate causes of mortality following colon cancer operations across hospitals. They found significant variation in mortality across hospitals for colon cancer operations, reflecting a need for improved operative decision-making to enhance outcomes and quality of care.
AHRQ-funded; HS020937; HS023621; HS000053.
Citation: Healy MA, Grenda TR, Suwanabol PA .
Colon cancer operations at high- and low-mortality hospitals.
Surgery 2016 Aug;160(2):359-65. doi: 10.1016/j.surg.2016.04.035.
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Keywords: Adverse Events, Cancer: Colorectal Cancer, Mortality, Patient Safety, Surgery
Laccetti AL, Pruitt SL, Xuan L
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Researchers identified patients > 65 years of age diagnosed 1992-2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. They found that, for patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Pruitt SL, Xuan L .
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Lung Cancer 2016 Aug;98:106-13. doi: 10.1016/j.lungcan.2016.05.029.
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Keywords: Elderly, Cancer: Lung Cancer, Medicare, Mortality, Patient-Centered Outcomes Research
Mehta HB, Parmar AD, Adhikari D
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
This study's objective was to evaluate the relative effects of surgeon and hospital volume on mortality and complications after pancreatic resection among older patients. The researchers used Texas Medicare data and found that high surgeon volume and high hospital volume were associated with lower risk of mortality, while high surgeon volume was also associated with lower risk of complications.
AHRQ-funded; HS022134.
Citation: Mehta HB, Parmar AD, Adhikari D .
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
J Surg Res 2016 Aug;204(2):326-34. doi: 10.1016/j.jss.2016.05.008.
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Keywords: Adverse Events, Elderly, Hospitals, Mortality, Surgery
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
Sloan CD, Gebretsadik T, Rosas-Salazar C
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
The researchers analyzed ecological associations between timing of Sudden Unexplained Infant Death (SUID) cases, bronchiolitis, and apnea healthcare visits. They found a temporal relationship between infant bronchiolitis and apnea, but no peak in SUID cases during peaks of bronchiolitis. They concluded that consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases.
AHRQ-funded; HS018454.
Citation: Sloan CD, Gebretsadik T, Rosas-Salazar C .
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
PLoS One 2016 Jul 12;11(7):e0158521. doi: 10.1371/journal.pone.0158521.
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Keywords: Newborns/Infants, Respiratory Conditions, Mortality
Park JK, Yang JA, Ahn EY
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
The researchers compared the outcomes of gastric, colon, lung, and breast cancer patients with and without rheumatic diseases. They found that rheumatoid arthritis and dermatomyositis/polymyositis seemed to be associated with a higher mortality in patients with lung or breast cancers, whereas systemic sclerosis seemed to be associated with decreased mortality in patients with lung cancer.
AHRQ-funded; HS018517.
Citation: Park JK, Yang JA, Ahn EY .
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
BMC Cancer 2016 Jul 4;16:381. doi: 10.1186/s12885-016-2444-5.
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Keywords: Cancer, Mortality, Arthritis, Skin Conditions
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Moore JX, Donnelly JP, Griffin R
Defining sepsis mortality clusters in the United States.
The researchers aimed to identify US counties with high sepsis mortality and to assess the community characteristics associated with increased sepsis mortality. They found that sepsis mortality is higher in the southern United States and that regions of high sepsis mortality are characterized by lower education, income, employment, and insurance coverage.
AHRQ-funded; HS013852.
Citation: Moore JX, Donnelly JP, Griffin R .
Defining sepsis mortality clusters in the United States.
Crit Care Med 2016 Jul;44(7):1380-7. doi: 10.1097/ccm.0000000000001665.
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Keywords: Mortality, Sepsis, Social Determinants of Health
Jiang HJ, Reiter KL, Wang J
AHRQ Author: Jiang HJ
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
This study assessed mortality performance of safety-net hospitals (SNHs) using all-payer databases and measures for a broad range of conditions and procedures. It found small differences in risk-adjusted mortality rates between SNHs and non-SNHs only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates.
AHRQ-authored.
Citation: Jiang HJ, Reiter KL, Wang J .
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
Med Care 2016 Jul;54(7):648-56. doi: 10.1097/mlr.0000000000000540.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Mortality, Provider Performance