Publications by authors named "McKenna R Nevers"
Article Synopsis
- The study analyzed pneumonia diagnoses in patients admitted to U.S. Veterans Affairs medical centers from the emergency department from January 2015 to January 2022, focusing on discrepancies in initial, discharge, and radiographic diagnoses. !* -
- Out of 2,383,899 hospitalizations, about 13.3% were diagnosed with pneumonia, with a significant 57% experiencing discordance between initial and discharge diagnoses. !* -
- Findings indicated that uncertainty in diagnoses was common, especially in high-complexity hospitals, and that patients without an initial pneumonia diagnosis faced a higher 30-day mortality rate compared to those with consistent diagnoses. !*
Importance: Non-ventilator-associated hospital-acquired pneumonia (NV-HAP) is a common and deadly hospital-acquired infection. However, inconsistent surveillance methods and unclear estimates of attributable mortality challenge prevention.
Objective: To estimate the incidence, variability, outcomes, and population attributable mortality of NV-HAP.
Electronic surveillance criteria for non-ventilator-associated hospital-acquired pneumonia: Assessment of reliability and validity.
Infect Control Hosp Epidemiol
March 2023
Objective: Surveillance of non-ventilator-associated hospital-acquired pneumonia (NV-HAP) is complicated by subjectivity and variability in diagnosing pneumonia. We compared a fully automatable surveillance definition using routine electronic health record data to manual determinations of NV-HAP according to surveillance criteria and clinical diagnoses.
Methods: We retrospectively applied an electronic surveillance definition for NV-HAP to all adults admitted to Veterans' Affairs (VA) hospitals from January 1, 2015, to November 30, 2020.
Objective: To determine whether a clinician-directed acute respiratory tract infection (ARI) intervention was associated with improved antibiotic prescribing and patient outcomes across a large US healthcare system.
Design: Multicenter retrospective quasi-experimental analysis of outpatient visits with a diagnosis of uncomplicated ARI over a 7-year period.
Participants: Outpatients with ARI diagnoses: sinusitis, pharyngitis, bronchitis, and unspecified upper respiratory tract infection (URI-NOS).
Background: Deaths from pneumonia were decreasing globally prior to the COVID-19 pandemic, but it is unclear whether this was due to changes in patient populations, illness severity, diagnosis, hospitalization thresholds, or treatment. Using clinical data from the electronic health record among a national cohort of patients initially diagnosed with pneumonia, we examined temporal trends in severity of illness, hospitalization, and short- and long-term deaths.
Design: Retrospective cohort PARTICIPANTS: All patients >18 years presenting to emergency departments (EDs) at 118 VA Medical Centers between 1/1/2006 and 12/31/2016 with an initial clinical diagnosis of pneumonia and confirmed by chest imaging report.