A5067416147- Acute Kidney Injury Research
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Advanced Causal Inference Techniques
- Chronic Kidney Disease and Diabetes
- Mycobacterium research and diagnosis
- Pulmonary Hypertension Research and Treatments
- Medication Adherence and Compliance
- Tuberculosis Research and Epidemiology
- Health Literacy and Information Accessibility
- Patient-Provider Communication in Healthcare
- Breastfeeding Practices and Influences
- Statistical Methods and Bayesian Inference
- Pharmaceutical Practices and Patient Outcomes
- Obesity, Physical Activity, Diet
- Heart Failure Treatment and Management
- Child Development and Digital Technology
- Sepsis Diagnosis and Treatment
- Statistical Methods and Inference
- COVID-19 Clinical Research Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Dialysis and Renal Disease Management
- Chronic Disease Management Strategies
- Opioid Use Disorder Treatment
- Diabetes Management and Research
Vanderbilt University Medical Center
2012-2025
Vanderbilt University
2010-2022
VA Tennessee Valley Healthcare System
2011-2020
Valley Health System
2012
University of Louisville
2012
Geriatric Research Education and Clinical Center
2010-2011
Pulmonary and Allergy Associates
2011
Statistical Service
2011
Brigham and Women's Hospital
2010
Harvard University
2010
To validate a diagnostic instrument for pediatric delirium in critically ill children, both ventilated and nonventilated, that uses standardized, developmentally appropriate measurements.A prospective observational cohort study investigating the Pediatric Confusion Assessment Method Intensive Care Unit (pCAM-ICU) patients medical, surgical, cardiac intensive care unit of university-based medical center.A total 68 patients, at least 5 years age, were enrolled from July 1, 2008, to March 30,...
Limited health literacy is common in the United States and associates with poor clinical outcomes. Little known about effect of patients advanced kidney disease. In this prospective cohort study we describe prevalence limited examine its association risk for mortality hemodialysis patients. We enrolled 480 incident chronic from 77 dialysis clinics between 2005 2007 followed them until April 2008. Measured using Rapid Estimate Adult Literacy Medicine, 32% had (<9th grade reading level) 68%...
Abstract Objective To evaluate whether early initiation of prophylactic anticoagulation compared with no was associated decreased risk death among patients admitted to hospital coronavirus disease 2019 (covid-19) in the United States. Design Observational cohort study. Setting Nationwide receiving care Department Veterans Affairs, a large integrated national healthcare system. Participants All 4297 from 1 March 31 July 2020 laboratory confirmed severe acute respiratory syndrome 2...
AKI associates with an increased risk for the development and progression of CKD mortality. Processes care after episode are not well described. Here, we examined likelihood nephrology referral among survivors at subsequent decline in kidney function a US Department Veterans Affairs database. We identified 3929 hospitalized between January 2003 December 2008 who had estimated GFR (eGFR) <60 ml/min per 1.73 m(2) 30 days peak injury. analyzed time to considering improvement (eGFR ≥60 m(2)),...
To examine the bias introduced by using time-fixed methodology to analyze effects of a time-varying exposure incurred in intensive care unit.Prospective cohort and Monte Carlo simulation studies.Medical coronary units university hospital.A total 224 mechanically ventilated patients.Part I was case study analyzing association between delirium unit (exposure variable) outcomes (intensive length stay 6-mo mortality) prospective study. Part II generating 16,000 data sets wherein true...
Recurrent AKI is common among patients after hospitalized and associated with progressive CKD. In this study, we identified clinical risk factors for recurrent present during index hospitalizations that occurred between 2003 2010 using a regional Veterans Administration database in the United States. was defined as 0.3 mg/dl or 50% increase from baseline creatinine measure. The primary outcome hospitalization within 12 months of discharge hospitalization. Time to examined Cox regression...
ACADEMIC EMERGENCY MEDICINE 2011; 18:451–457 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: The consequences of delirium in emergency department (ED) remain unclear. This study sought to determine if ED was an independent predictor prolonged hospital length stay (LOS). Methods: prospective cohort conducted at a tertiary care, academic from May 2007 August 2008. included English‐speaking patients aged 65 and older who were less than 12 hours enrollment. Patients...
Baseline creatinine (BCr) is frequently missing in AKI studies. Common surrogate estimates can misclassify and adversely affect the study of related outcomes. This examined whether multiple imputation improved accuracy estimating BCr beyond current recommendations to apply assumed estimated GFR (eGFR) 75 ml/min per 1.73 m(2) (eGFR 75).From 41,114 unique adult admissions (13,003 with 28,111 without data) at Vanderbilt University Hospital between 2006 2008, a propensity score model was...
OBJECTIVE: To examine parental reports of feeding and activity behaviors in a cohort parents 2-month-olds how they differ by race/ethnicity. METHODS: Parents participating Greenlight, cluster, randomized trial obesity prevention at 4 health centers, were queried enrollment about thought to increase risk. Unadjusted associations between race/ethnicity the outcomes interest performed using Pearson χ2 Kruskal-Wallis tests. Adjusted analyses proportional odds logistic regressions. RESULTS: Eight...
Abstract We study rank‐based approaches to estimate the correlation between two right‐censored variables. With end‐of‐study censoring, it is often impossible nonparametrically identify complete bivariate survival distribution, and therefore compute Spearman's rank correlation. As a solution, we propose measures that can be estimated. The first measure in restricted region. second for an altered but estimable joint distribution. describe population parameters these illustrate how they are...
Background— Medication errors and adverse drug events are common after hospital discharge due to changes in medication regimens, suboptimal instructions, prolonged time follow-up. Pharmacist-based interventions may be effective promoting the safe use of medications, especially among high-risk patients such as those with low health literacy. Methods Results— The Pharmacist Intervention for Low Literacy Cardiovascular Disease (PILL-CVD) study is a randomized controlled trial conducted at 2...
We examined the effect of hospital admissions on medical treatment poorly controlled diabetes mellitus among Veterans Affairs (VA) patients.This retrospective cohort study included male patients admitted to one three VA hospitals from July 1, 2002, August 31, 2009, who were receiving medication therapy for with hemoglobin A1c (HgbA1c) greater than 8.0%. The primary outcome was a change in preadmission and outpatient prescriptions at discharge. Covariates multivariable logistic regression...
Patients' ability to accurately report their preadmission medications is a vital aspect of medication reconciliation, and may affect subsequent adherence safety. Little known about predictors understanding.We conducted cross-sectional evaluation patients at 2 hospitals using novel Medication Understanding Questionnaire (MUQ). MUQ scores range from 0 3 test knowledge the purpose, dose, frequency. We used multivariable ordinal regression determine higher scores.Among 790 eligible patients,...
Fluoroquinolone resistance in Mycobacterium tuberculosis can be conferred by mutations gyrA or gyrB. The prevalence of outside the quinolone resistance-determining region (QRDR) gyrB is unclear, since such regions are rarely sequenced. M. isolates from 1,111 patients with newly diagnosed culture-confirmed Tennessee 2002 to 2009 were screened for phenotypic ofloxacin (>2 μg/ml). For each resistant isolate, two ofloxacin-susceptible selected: one antecedent fluoroquinolone exposure and...
Abstract Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset key step towards AKI prevention. Materials Methods A national retrospective cohort 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled electronic health record (EHR) data collected 2003 2012. HA-AKI defined at stage 1+, 2+, dialysis. EHR-based predictors were identified through...
The aim of this study was to assess the sensitivity, specificity and time results mycobacterial growth indicator tube (MGIT) 960, microscopic observation drug susceptibility (MODS) assay nitrate reductase (NRA) compared with gold standard agar proportion method (PM), determine whether there is cross-resistance between older-generation fluoroquinolones moxifloxacin. Mycobacterium tuberculosis isolates from culture-confirmed patients 2002 2007 were tested for ofloxacin (2 mg/L) resistance by...
Background Patients with hospitalized acute kidney injury (AKI) are at increased risk for accelerated loss of function, morbidity, and mortality. We sought to inform efforts improving post-AKI outcomes by describing the receipt renal-specific laboratory test surveillance among a large high-risk cohort. Methods acquired clinical data from Electronic health record (EHR) 5 Veterans Affairs (VA) hospitals identify patients AKI January 1st, 2002 December 31st, 2009, followed these 1 year or until...