Prophylactic Vancomycin Leads to Fewer Device Removals in Sacral Neuromodulation.

Importance: Sacral neuromodulation (SNM) requires removal for infectious complications in 3-11%.

Objective: The objective of this study was to examine the effect of preoperative antibiotic choice on all-cause SNM device removal rates.

Study Design: This was a retrospective cohort analysis, using the Health Facts Database, representing more than 750 hospitals.

Hemoglobin A1c and Reoperation After Surgery for Stress Incontinence or Prolapse.

Importance: Few studies compare the link between hemogobin A1c (HbA1c) and urogynecologic surgical complications.

Objective: The objective of this study was to determine the association between HbA1c and reoperation in women undergoing surgery for stress urinary incontinence (SUI) or pelvic organ prolapse (POP).

Study Design: We performed 2 separate retrospective cohort analyses using Cerner's HealthFacts Database (750 hospitals; 519,000,000 patient encounters from January 1, 2010, to November 30, 2018).

Electronic health record data quality variability across a multistate clinical research network.

Background: Electronic health record (EHR) data have many quality problems that may affect the outcome of research results and decision support systems. Many methods have been used to evaluate EHR data quality. However, there has yet to be a consensus on the best practice.

Characterizing Opioid Use Disorder Encounters in the Midwest Region, USA.

Introduction: The opioid epidemic has taken its toll on the Midwest, a census region of the USA. The Midwest includes two census divisions: East North Central and West North Central. This study aimed (1) to characterize patient encounters of opioid use disorder (OUD) in the Midwest using the Health Facts database; and (2) to compare selected patient and facility characteristics between the two census divisions.

Inpatient prescribing patterns of long-acting injectables and their oral or short-acting injectable equivalent formulations.

Long-acting injectable (LAI) antipsychotics (APs) each have an oral equivalent formulation, while aripiprazole, olanzapine, and ziprasidone each also have a short-acting injectable (SAI) equivalent formulation. Inpatient prescribing patterns of LAIs and their oral/SAI equivalents are less characterized in populations other than Medicaid, Medicare, and Veterans Affairs populations. Mapping out inpatient prescribing patterns remains an important first step to ensure appropriate use of antipsychotics during this critical juncture of patient care prior to discharge.

Tailoring Rule-Based Data Quality Assessment to the Patient-Centered Outcomes Research Network (PCORnet) Common Data Model (CDM).

Individual researchers and research networks have developed and applied different approaches to assess the data quality of electronic health record (EHR) data. A previously published rules-based method to evaluate the data quality of EHR data provides deeper levels of data quality analysis. To examine the effectiveness and generalizability of the rule-based framework, we reprogrammed and translated published rule templates to operate against the PCORnet Common Data Model and executed them against a database for a single center of the Greater Plains Collaborative (GPC) PCORnet Clinical Research Network.

Reoperation rates of stress incontinence surgery in rural vs urban hospitals.

Background: XXX.

Objective: This study aimed to determine the impact of a rural vs urban hospital location on the risk of undergoing a second surgery for stress urinary incontinence.

Study Design: Using the Cerner Health Facts nationwide electronic medical record database, we identified patients who underwent surgeries for stress incontinence between January 1, 2010 and November 30, 2018.

Examining Geographic Variation of Opioid Use Disorder Encounters in the USA.

Objectives: The objectives were (1) to characterize patient encounters of opioid use disorder (OUD) using Health Facts database; and (2) to identify geographic variation, patient characteristics, and facility characteristics impacting patients' reduced OUD encounters over time.

Methods: Patient encounters were included if the patient (1) was 18 years old or greater; (2) had an index encounter; (3) survived at least 30 days after the discharge. The OUD encounter was based on ICD-10 codes.

Risk factors for the development of acute pyelonephritis in women with a positive urine culture.

Introduction: In treating lower urinary tract symptoms (LUTS), the risk of overtreatment with antibiotics must be reconciled with the risk of an untreated urinary tract infection (UTI) progressing to acute pyelonephritis (APN). Using Cerner HealthFacts, a longitudinal clinical informatics database, we aimed to determine risk factors associated with the development of APN from UTI in an effort to guide the initiation of empiric antibiotics.

Methods: We queried the Cerner HealthFacts database for women over age 18 with a positive urine culture.

Health Facts Medication Adherence in Transplantation (H-MAT) Study: A Secondary Analysis of Determinants and Outcomes of Medication Nonadherence in Adult Kidney Transplant Recipients.

Aims: To explore the relationship between determinants and posttransplant medication nonadherence (MNA) in adult kidney transplant recipients, and to examine the relationship between posttransplant MNA and clinical outcomes.

Methods: Using the World Health Organization's model, this retrospective, multicenter, correlational study examined the relationship between determinants, posttransplant MNA, and clinical outcomes in 16,671 adult kidney transplant recipients from the Cerner national data warehouse.

Results: With 12% MNA, those who were nonadherent were more likely to have the social/economic factors of being younger, single, Caucasian versus Hispanic race, have the condition-related factor of mental health/substance use disorder, and have the healthcare system-related factor of government/health maintenance organization/managed care insurance (' < 0.

Renin-Angiotensin Blockade Reduces Readmission for Acute Chest Syndrome in Sickle Cell Disease.

Rationale Acute chest syndrome (ACS) is a life-threatening complication of sickle cell disease (SCD). Current treatment is supportive-supplemental oxygen, transfusions, and antibiotics. Prevention of ACS may reduce morbidity and mortality in patients with SCD.

Gastroesophageal Reflux Disease-Associated Chronic Cough: A Population-Based Analysis of Patient Presentations in the United States.

Gastroesophageal reflux disease is an extremely prevalent illness in the United States; however, clinicians report that its association with chronic cough is often overlooked and undiagnosed. We used the CERNER Health Facts database to analyze the statistical prevalence. Our findings indicate that there is a minority of patients who are untreated for this common complaint.

The Risk of Primary Uterine and Cervical Cancer After Hysteropexy.

Objective: The aim of the study was to determine the rate of subsequent uterine/cervical cancer after hysteropexy compared with hysterectomy with apical prolapse repair.

Methods: The study used a retrospective cohort of women with uterovaginal prolapse using the Cerner Health Facts database between 2010 and 2018. We identified sacrospinous or uterosacral ligament suspensions or sacral colpopexy/hysteropexy and excluded those with previous hysterectomy.

The Use of Direct Oral Anticoagulants in the Management of Venous Thromboembolism in Patients With Obesity.

Introduction The use of direct oral anticoagulants (DOACs) has gained significant traction given the lack of therapeutic monitoring and the need for anticoagulant bridging. There is a paucity of data on their effectiveness in obese patients with venous thromboembolism (VTE). Preliminary subgroup and pharmacokinetic analyses suggest reduced efficacy in those with a bodyweight >120 kg or body mass index (BMI) ≥40 kg per m and it is currently not recommended that these agents be used as first-line agents.

Risk Factors for Returning to the Operating Room for a Second Surgery After Midurethral Sling for Stress Urinary Incontinence.

Objectives: The objective of this study was to identify risk factors for having to return to the operating room for a second surgery after midurethral sling (MUS).

Methods: We used a case-control design. Cases return to operating room were a composite of 6 surgical complications or recurrent stress urinary incontinence because we believed that women would consider return to the operating room (OR) a similar MUS-related complication regardless of indication.

High prevalence of comorbid autoimmune diseases in adults with type 1 diabetes from the HealthFacts database.

Background: Patients with type 1 diabetes (T1D) are at risk for other autoimmune diseases (ie, polyautoimmunity). The prevalence and risk factors of this phenomenon have been underreported in adults and ethnic minorities, and data are lacking regarding non-endocrine autoimmune diseases.

Methods: Study population data were gathered from HealthFacts, a deidentified patient database compiled from electronic medical records systems in the US.