National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (6)
- Asthma (1)
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- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (1)
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- Medication: Safety (1)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (3)
- Outcomes (4)
- Patient-Centered Outcomes Research (1)
- (-) Patient Safety (15)
- Quality Improvement (1)
- Quality of Care (1)
- (-) Registries (15)
- Respiratory Conditions (1)
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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 15 of 15 Research Studies DisplayedBrei BK, Sawyer T, Umoren R
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
This study looked at whether the presence of family members had an impact on neonatal tracheal intubation (TI) outcomes. This retrospective analysis looked at TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS) at 13 academic NICUS from October 2014 to December 2017. Family members were present in less than 10% of TIs, but this varied by site. Success rates were not significantly different, with the first attempt success rate at 55% with family present versus 49% and success within 2 attempts was 74% versus 66%. Adverse TI-associated events (TIAEs) were 17% versus 20% and severe oxygen desaturation was 49% versus 52%. No independent association between any of these outcomes was found with family presence.
AHRQ-funded; HS027259; HS024511.
Citation: Brei BK, Sawyer T, Umoren R .
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
Arch Dis Child Fetal Neonatal Ed 2021 Jul;106(4):392-97. doi: 10.1136/archdischild-2020-319709..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Registries, Patient Safety
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation: Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
Branca A, Tellez D, Berkenbosch J
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Researchers evaluated the effect of the timing of the PICU fellow academic cycle on tracheal intubation-associated events in a retrospective cohort study of 37 PICUs participating in the National Emergency Airway Registry for Children.. They found that the New Trainee Effect in tracheal intubation safety outcomes was not observed in various types of PICUs. There was a significant improvement in pediatric critical care medicine fellows' first attempt success and a significant decline in tracheal intubation-associated event rates, indicating substantial skills acquisition throughout pediatric critical care medicine fellowship.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Branca A, Tellez D, Berkenbosch J .
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2020 Dec;21(12):1042-50. doi: 10.1097/pcc.0000000000002480..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Registries, Education: Continuing Medical Education, Training
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation: Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Lee BY, Bartsch SM, Hayden MK
How introducing a registry with automated alerts for carbapenem-resistant Enterobacteriaceae (CRE) may help control CRE spread in a region.
This study examined the effectiveness of implementing a registry which tracks patients that carry antibiotic-resistant bacteria, including carbapenem-resistant Enterobacteriaceae (CRE). The researchers developed an agent-based model of all inpatient healthcare facilities in the Chicago metropolitan area and surrounding areas. They used their Regional Healthcare Ecosystem Analyst software platform to study patient flow. They created scenarios where all, 75%, 50%, and 25% of Chicago-area facilities participated. Even at 25% participation there was a 9.1% relative reduction in incident carriers and 2.8% relative reduction of prevalence. At 100% there was an 11.6% relative reduction in new carrier and CRE prevalence by 7.6%.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Hayden MK .
How introducing a registry with automated alerts for carbapenem-resistant Enterobacteriaceae (CRE) may help control CRE spread in a region.
Clin Infect Dis 2020 Feb 14;70(5):843-49. doi: 10.1093/cid/ciz300..
Keywords: Registries, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Ozawa Y, Ades A, Foglia EE
Premedication with neuromuscular blockade and sedation during neonatal intubation is associated with fewer adverse events.
This study assessed the impact of using sedation with neuromuscular blockade in non-emergency tracheal intubation of neonates. The retrospective cohort was from infants in neonatal intensive care units (NICUs) participating the National Emergency Airway Registry for Neonates from 2014 to 2017. There was less adverse events associated with use of the neuromuscular blockade premedication.
AHRQ-funded; HS024511.
Citation: Ozawa Y, Ades A, Foglia EE .
Premedication with neuromuscular blockade and sedation during neonatal intubation is associated with fewer adverse events.
J Perinatol 2019 Jun;39(6):848-56. doi: 10.1038/s41372-019-0367-0..
Keywords: Adverse Events, Medication, Newborns/Infants, Outcomes, Patient Safety, Registries
Sanders R, Edwards L, Nishisaki A
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
This editorial discusses a research study on outcomes of performing pediatric trachael intubations (TIs) and how the results can be applied to performing intubations on critically ill children in the United Kingdom outside of specialized centers. One of the authors is from a U.S. site that submits its airway management data to the National Emergency Airway Registry for Children (NEAR4KIDS). The results from the registry were compared to the results from the study. A total of 1,051 patients out of 1,237 eligible patients were analyzed. The results came from 47 nonspecialized local hospitals in the North Thames and East Anglia region of the UK. Adverse TI-associated events (TIAEs) occurred in 22.7% of the patients, which is higher than those in PICUs and cardiac ICUs. The majority of intubations were performed by the anesthesiologist in the team. The results were similar to those in the NEAR4KIDS registry. There were more complications with children with a higher grade of airway difficulties and comorbidities. The authors believe that pediatric airway management for acutely ill children would benefit from new strategies. They recommend a system change using Plan, Do, Study, Act (PDSA) cycles.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Sanders R, Edwards L, Nishisaki A .
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
Pediatr Crit Care Med 2019 Jun;20(6):572-73. doi: 10.1097/pcc.0000000000001946..
Keywords: Adverse Events, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Outcomes, Patient Safety, Registries, Respiratory Conditions
Foglia EE, Ades A, Sawyer T
Neonatal intubation practice and outcomes: an international registry study.
Neonatal tracheal intubation is a critical but potentially dangerous procedure. In this study, the investigators sought to characterize intubation practice and outcomes in the NICU and delivery room (DR) settings and to identify potentially modifiable factors to improve neonatal intubation safety. They developed the National Emergency Airway Registry for Neonates and collected standardized data for patients, providers, practices, and outcomes of neonatal intubation. They suggest that their results will inform future interventional studies to improve neonatal intubation safety.
AHRQ-funded; HS024511.
Citation: Foglia EE, Ades A, Sawyer T .
Neonatal intubation practice and outcomes: an international registry study.
Pediatrics 2019 Jan;143(1). doi: 10.1542/peds.2018-0902..
Keywords: Emergency Department, Health Services Research (HSR), Intensive Care Unit (ICU), Newborns/Infants, Outcomes, Patient Safety, Registries
Bates J, Parzynski CS, Dhruva SS
Quantifying the utilization of medical devices necessary to detect postmarket safety differences: a case study of implantable cardioverter defibrillators.
The purpose of this study was to estimate medical device utilization needed to detect safety differences among implantable cardioverter defibrillators (ICDs) generator models and compare these estimates to utilization in practice. The investigators concluded that small safety differences among ICD generator models are unlikely to be detected through routine surveillance given current ICD utilization in practice, but large safety differences can be detected for most patients at anticipated average adverse event rates.
AHRQ-funded; HS022882.
Citation: Bates J, Parzynski CS, Dhruva SS .
Quantifying the utilization of medical devices necessary to detect postmarket safety differences: a case study of implantable cardioverter defibrillators.
Pharmacoepidemiol Drug Saf 2018 Aug;27(8):848-56. doi: 10.1002/pds.4565..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Medical Devices, Patient Safety, Registries, Surgery
Ross JS, Bates J, Parzynski CS
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, the researchers applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models. The three approaches, including one machine learning method, identified important safety signals, but without exact agreement.
AHRQ-funded; HS023000.
Citation: Ross JS, Bates J, Parzynski CS .
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Med Devices 2017 Aug 16;10:165-88. doi: 10.2147/mder.s138158.
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Keywords: Medical Devices, Registries, Patient Safety, Adverse Events
Ayvaz S, Horn J, Hassanzadeh O
Toward a complete dataset of drug-drug interaction information from publicly available sources.
The researchers combined all the publicly available sources of potential drug-drug interaction information using a common data model after conducting a comprehensive and broad search. They examined the overlap between and across the data sources. Their analysis determined that there was little overlap and that there is heterogeneity between the information provided by each source.
AHRQ-funded; HS019461.
Citation: Ayvaz S, Horn J, Hassanzadeh O .
Toward a complete dataset of drug-drug interaction information from publicly available sources.
J Biomed Inform 2015 Jun;55:206-17. doi: 10.1016/j.jbi.2015.04.006..
Keywords: Medication, Patient Safety, Registries, Health Information Technology (HIT)
Krell RW, Regenbogen SE, Wong SL
Variation in hospital treatment patterns for metastatic colorectal cancer.
This study used national clinical registry data to assess treatment patterns for patients with metastatic colorectal cancer (CRC). The goal was to determine the degree to which different treatment modalities such as metastatic site surgery or multiagent chemotherapy can characterize a hospital’s overall “aggressiveness” in treatment. It found that hospitals with high volumes of service consistently using more metastatic site resection and multiagent chemotherapy than hospitals with low volumes of service.
AHRQ-funded; HS020937.
Citation: Krell RW, Regenbogen SE, Wong SL .
Variation in hospital treatment patterns for metastatic colorectal cancer.
Cancer 2015 Jun 1;121(11):1755-61. doi: 10.1002/cncr.29253..
Keywords: Treatments, Registries, Hospitals, Patient Safety
Scialla JJ, Liu J, Crews DC
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
The estimated glomerular filtration rate (eGFR) at dialysis initiation has been rising. This study described geographic variation in estimated glomerular filtration rate (eGFR) at dialysis initiation and determine its association with mortality. It found no associated harm or benefit with early dialysis initiation in the United States.
AHRQ-funded; 290200500341I.
Citation: Scialla JJ, Liu J, Crews DC .
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
Kidney Int 2014 Oct;86(4):798-809. doi: 10.1038/ki.2014.110..
Keywords: Kidney Disease and Health, Outcomes, Patient Safety, Registries