National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Behavioral Health (2)
- Blood Clots (1)
- Blood Pressure (3)
- Blood Thinners (4)
- Cancer: Colorectal Cancer (1)
- Cancer: Skin Cancer (1)
- (-) Cardiovascular Conditions (66)
- Care Management (1)
- Case Study (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Community-Based Practice (2)
- Comparative Effectiveness (4)
- Critical Care (1)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (2)
- Elderly (8)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (6)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (2)
- Health Promotion (2)
- Heart Disease and Health (27)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (2)
- Injuries and Wounds (1)
- Inpatient Care (2)
- Kidney Disease and Health (2)
- Lifestyle Changes (1)
- Low-Income (1)
- Medical Devices (2)
- Medical Errors (1)
- Medicare (1)
- Medication (14)
- Mortality (4)
- Neurological Disorders (2)
- Nutrition (1)
- Obesity (1)
- Outcomes (6)
- Patient-Centered Outcomes Research (16)
- Patient Adherence/Compliance (2)
- Patient Safety (5)
- Policy (1)
- Prevention (6)
- Primary Care (1)
- Racial and Ethnic Minorities (8)
- Registries (5)
- Respiratory Conditions (1)
- Risk (15)
- Sex Factors (2)
- Social Determinants of Health (3)
- Stroke (9)
- Surgery (8)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (1)
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 66 Research Studies DisplayedDesai NR, Parzynski CS, Krumholz HM
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
The researchers sought to determine whether internal review of percutaneous coronary intervention (PCI) appropriateness using appropriate use criteria is associated with differences in procedural appropriateness, quality of care, and patient outcomes. They concluded that there was a modest association between procedural appropriateness and clinical outcomes and a similarly modest correlation between nonacute PCI volume and procedural appropriateness.
AHRQ-funded; HS023000
Citation: Desai NR, Parzynski CS, Krumholz HM .
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
JAMA Intern Med. 2015 Dec;175(12):1988-90.
Keywords: Cardiovascular Conditions, Patient-Centered Outcomes Research, Heart Disease and Health, Registries
Lewis MW, Khodneva Y, Redmond N
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
The authors investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. They found that, for younger individuals, low income, regardless of education, was associated with higher risk of CHD; however, this was not observed for those 65 years of age or older.
AHRQ-funded; HS023009.
Citation: Lewis MW, Khodneva Y, Redmond N .
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
BMC Public Health 2015 Dec 29;15:1312. doi: 10.1186/s12889-015-2630-4.
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Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Social Determinants of Health, Stroke
Murugiah K, Wang Y, Desai NR
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
The researchers studied hospital performance on transcatheter aortic valve replacement (TAVR) using data from all Medicare fee-for-service (FFS) beneficiaries 65 years of age and older who underwent TAVR from January 1, 2011, to December 31, 2013. They found that for an individual patient, the between-hospital variation translates to a great than 2-fold higher risk of dying within 30 days for a patient undergoing TAVR at a hospital 1 SD above the national average compared with undergoing TAVR at a hospital 1 SD below; the between-hospital variation was
AHRQ-funded; HS023000.
Citation: Murugiah K, Wang Y, Desai NR .
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
J Am Coll Cardiol 2015 Dec 15;66(23):2678-79. doi: 10.1016/j.jacc.2015.10.008.
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Keywords: Cardiovascular Conditions, Hospitals, Medicare, Patient-Centered Outcomes Research, Surgery
Spatz ES, Jiang X, Lu J
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
The Qingdao Port Cardiovascular Health Study was designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Early findings reveal a significant increase in cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, and body mass index) from 2000 to 2010.
AHRQ-funded; HS023000.
Citation: Spatz ES, Jiang X, Lu J .
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
BMJ Open 2015 Dec 9;5(12):e008403. doi: 10.1136/bmjopen-2015-008403.
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Keywords: Cardiovascular Conditions, Risk, Social Determinants of Health, Patient-Centered Outcomes Research, Prevention
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
Du XL, Zhang Y
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
This study sought to determine the relationship between the receipt of colony-stimulating factors (CSFs) with erythropoiesis-stimulating agents (ESAs) and the risk of developing venous thromboembolism (VTE), stroke, heart disease, and myelodysplastic syndrome (MDS) in patients with colorectal cancer. It found that the use of ESAs was significantly associated with a substantially increased risk of MDS in patients with colorectal cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y .
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
Clin Colorectal Cancer 2015 Dec;14(4):e21-31. doi: 10.1016/j.clcc.2015.05.007.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai NR, Bradley SM, Parzynski CS
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
The researchers examined trends in percutaneous coronary intervention (PCI) utilization, patient selection, and procedural appropriateness following the introduction of Appropriate Use Criteria. They concluded that there have been significant reductions in the volume of nonacute PCI. The proportion of nonacute PCIs classified as inappropriate has declined, although hospital-level variation in inappropriate PCI persists.
AHRQ-funded; HS023000.
Citation: Desai NR, Bradley SM, Parzynski CS .
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
JAMA 2015 Nov 17;314(19):2045-53. doi: 10.1001/jama.2015.13764.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Utilization
Weiner BJ, Pignone MP, DuBard CA
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
The objective of Heart Health NOW (HHN) is to determine if primary care practice support a comprehensive evidence-based quality improvement strategy involving practice facilitation, academic detailing, technology support, and regional learning collaboratives—accelerates widespread dissemination and implementation of evidence-based guidelines for cardiovascular disease (CVD) prevention in small- to medium-sized primary care practices.
AHRQ-funded; HS023912.
Citation: Weiner BJ, Pignone MP, DuBard CA .
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
Implement Sci 2015 Nov 14;10:160. doi: 10.1186/s13012-015-0348-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care
Cooper LB, Hammill BG, Peterson ED
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
No large studies have examined whether laboratory monitoring occurs routinely in community practice. The researchers observed low rates of monitoring in clinical practice: after initiation of mineralocorticoid receptor antagonist therapy in a large cohort, only 1,384 patients (13.3 percent) and 3,122 patients (29.9 percent) received appropriate testing in early and extended follow-up, respectively.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
JAMA 2015 Nov 10;314(18):1973-5. doi: 10.1001/jama.2015.11904..
Keywords: Heart Disease and Health, Cardiovascular Conditions
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication
Goldberg J, Paugh TA, Dickinson TA
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
The researchers describe the relationship between acute normovolemic hemodilution (ANH) and red blood cell (RBC) transfusions after cardiac surgery using a multicenter registry. They found a significant association between ANH and reduced perioperative RBC transfusion in cardiac surgery. Transfusion reduction is most profound with larger volumes of ANH.
AHRQ-funded; HS022535; HS022909.
Citation: Goldberg J, Paugh TA, Dickinson TA .
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
Ann Thorac Surg 2015 Nov;100(5):1581-7; discussion 87. doi: 10.1016/j.athoracsur.2015.04.135.
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Keywords: Cardiovascular Conditions, Surgery, Registries
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Ellis MC, Paugh TA, Dickinson TA
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Recent literature has suggested that women, although more often exposed to lower nadir hematocrit (Hct), have a lower risk of postoperative renal dysfunction. The researchers assessed whether this relationship held across a large multicenter registry. They found that lower nadir Hct was associated with an increased risk of AKI, and the effect appears to be stronger among men than women.
AHRQ-funded; HS022535; HS022909.
Citation: Ellis MC, Paugh TA, Dickinson TA .
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Ann Thorac Surg 2015 Nov;100(5):1549-54; discussion 54-5. doi: 10.1016/j.athoracsur.2015.05.080..
Keywords: Risk, Cardiovascular Conditions, Surgery, Adverse Events, Patient Safety
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
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Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Silverberg JI
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
The authors sought to determine whether adult eczema is associated with increased cardiovascular and cerebrovascular disease. They concluded that adults with atopic dermatitis may have increased cardiovascular disease, heart attack, and stroke.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.
Allergy 2015 Oct;70(10):1300-8. doi: 10.1111/all.12685.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Cancer: Skin Cancer
Burns KM, Encinosa WE, Pearson GD
AHRQ Author: Encinosa WE
Electrocardiogram in preparticipation athletic evaluations among insured youths.
The researchers retrospectively characterized electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). They found that thirteen percent of PPEs with ECG and 0.5 percent of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18 percent (2 percent sports-limiting); after PPEs alone, cardiac disease was identified in 0.5 percent (0.03 percent sports-limiting).
AHRQ-authored.
Citation: Burns KM, Encinosa WE, Pearson GD .
Electrocardiogram in preparticipation athletic evaluations among insured youths.
J Pediatr 2015 Oct;167(4):804-09.e1. doi: 10.1016/j.jpeds.2015.06.011..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Siegler JE, Samai A, Albright KC
Factoring in factor VIII with acute ischemic stroke.
This review summarized the molecular role of factor VIII in thrombogenesis and its clinical use in the diagnosis and prognosis of acute ischemic stroke. It also discussed the utility of screening for serum factor VIII levels among patients at risk for, or those who have experienced, ischemic stroke.
AHRQ-funded; HS013852.
Citation: Siegler JE, Samai A, Albright KC .
Factoring in factor VIII with acute ischemic stroke.
Clin Appl Thromb Hemost 2015 Oct;21(7):597-602. doi: 10.1177/1076029615571630.
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Keywords: Stroke, Blood Clots, Cardiovascular Conditions
Doll JA, Hellkamp A, Ho PM
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
This study identified opportunities to improve the use of cardiac rehabilitation by older adults. It concluded that quality improvement efforts should focus not only on increasing referral rates but also on addressing barriers to attending rehabilitation sessions, such as travel distance, copayments, and lack of coordination between inpatient and outpatient clinicians.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp A, Ho PM .
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
JAMA Intern Med 2015 Oct;175(10):1700-2. doi: 10.1001/jamainternmed.2015.3819..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions
Wolfson J, Bandyopadhyay S, Elidrisi M
A Naive Bayes machine learning approach to risk prediction using censored, time-to-event data.
This paper proposed an adaptation of the well-known Naive Bayes machine learning approach to time-to-event outcomes subject to censoring. It compared the predictive performance of that method with the Cox proportional hazards model which is commonly used for risk prediction in healthcare populations, and illustrated its application to prediction of cardiovascular risk using an electronic health record dataset from a large Midwest integrated healthcare system.
AHRQ-funded; HS017622.
Citation: Wolfson J, Bandyopadhyay S, Elidrisi M .
A Naive Bayes machine learning approach to risk prediction using censored, time-to-event data.
Stat Med 2015 Sep 20;34(21):2941-57. doi: 10.1002/sim.6526..
Keywords: Risk, Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions
McNellis R, Lewis P
AHRQ Author: McNellis R
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This case study quiz is based on the recommendations of the USPSTF. The case concerns a 34-year-old man who smokes. When he presents for his annual checkup for hypertension, his blood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his last visit.
AHRQ-authored.
Citation: McNellis R, Lewis P .
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2015 Sep 15;92(6):509-10.
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Keywords: Behavioral Health, Cardiovascular Conditions, Case Study, Lifestyle Changes, Nutrition, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Ogedegbe G, Shah NR, Phillips C
Comparative effectiveness of angiotensin-converting enzyme inhibitor-based treatment on cardiovascular outcomes in hypertensive Blacks versus Whites.
This study evaluated the comparative effectiveness of an ACE inhibitor–based regimen on a composite outcome of all-cause mortality, stroke, and acute myocardial infarction (AMI) in hypertensive blacks compared with whites. ACE inhibitor–based therapy was associated with poorer cardiovascular outcomes in hypertensive blacks but not in whites.
AHRQ-funded; HS018589.
Citation: Ogedegbe G, Shah NR, Phillips C .
Comparative effectiveness of angiotensin-converting enzyme inhibitor-based treatment on cardiovascular outcomes in hypertensive Blacks versus Whites.
J Am Coll Cardiol 2015 Sep 15;66(11):1224-33. doi: 10.1016/j.jacc.2015.07.021..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cardiovascular Conditions, Racial and Ethnic Minorities, Medication
Thompson DA, Marsteller JA, Pronovost PJ
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
The objectives of the study were to develop a scientifically sound and feasible peer-to-peer assessment model that allows health-care organizations to evaluate patient safety in cardiovascular operating rooms and to establish safety priorities for improvement. It identified 6 top priority hazard themes: safety culture, teamwork and communication, infection prevention, transitions of care, failure to adhere to practices or policies, and operating room layout and equipment.
AHRQ-funded; HS013904.
Citation: Thompson DA, Marsteller JA, Pronovost PJ .
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
J Patient Saf 2015 Sep;11(3):143-51. doi: 10.1097/pts.0000000000000059..
Keywords: Patient Safety, Medical Errors, Adverse Events, Surgery, Cardiovascular Conditions, Prevention
Likosky DS, Paone G, Zhang M
Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting.
This study describes the relationship between red blood cell (RBC) transfusion and postoperative pneumonia after CABG. It found a significant volume dependent association between an increasing number of RBCs and the odds of pneumonia, which persisted after risk adjustment. It included a total of 16,182 consecutive patients who underwent isolated CABG between 2011 and 2013 at 1 of 33 hospitals in the state of Michigan.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Paone G, Zhang M .
Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting.
Ann Thorac Surg 2015 Sep;100(3):794-801. doi: 10.1016/j.athoracsur.2015.03.089..
Keywords: Surgery, Cardiovascular Conditions, Patient Safety