2023
Trends in use of antipsychotics and psychoactive drugs in older patients after major surgery
Kim D, Lee H, Pawar A, Lee S, Park C, Levin R, Metzger E, Bateman B, Ely E, Pandharipande P, Pisani M, Hohmann S, Marcantonio E, Inouye S. Trends in use of antipsychotics and psychoactive drugs in older patients after major surgery. Journal Of The American Geriatrics Society 2023, 71: 3755-3767. PMID: 37676699, PMCID: PMC10841351, DOI: 10.1111/jgs.18580.Peer-Reviewed Original ResearchConceptsUse of antipsychoticsAcademic medical centerCommunity hospitalPostoperative periodHospital typeSurgical admissionsOlder patientsMajor surgeryAtypical antipsychoticsPsychoactive drugsIntensive care unit settingRetrospective cohort studyUse of haloperidolNon-ICU settingsUse of antiepilepticsProfessional society guidelinesPostoperative deliriumPatients 65Cohort studyHospital daysHypnotic useAgonist dexmedetomidineSociety guidelinesUnit settingMedical CenterComparative Safety Analysis of Oral Antipsychotics for In-Hospital Adverse Clinical Events in Older Adults After Major Surgery : A Nationwide Cohort Study.
Kim D, Lee S, Park C, Levin R, Metzger E, Bateman B, Ely E, Pandharipande P, Pisani M, Jones R, Marcantonio E, Inouye S. Comparative Safety Analysis of Oral Antipsychotics for In-Hospital Adverse Clinical Events in Older Adults After Major Surgery : A Nationwide Cohort Study. Annals Of Internal Medicine 2023, 176: 1153-1162. PMID: 37665998, PMCID: PMC10625498, DOI: 10.7326/m22-3021.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAdverse clinical eventsHospital deathMajor surgeryClinical eventsPostoperative deliriumCohort studyOlder patientsAntipsychotic drugsArrhythmia eventsCardiac arrhythmia eventsHospital adverse clinical eventsModerate-dose treatmentPremier Healthcare DatabaseHospital adverse eventsNationwide cohort studyRetrospective cohort studyAtypical antipsychotic useOral antipsychotic drugsSignificant differencesHaloperidol useIschemic attackOral antipsychoticsAdverse eventsOral haloperidol
2016
Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors
Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors. American Journal Of Respiratory And Critical Care Medicine 2016, 194: 299-307. PMID: 26840348, PMCID: PMC4970594, DOI: 10.1164/rccm.201506-1256oc.Peer-Reviewed Original ResearchConceptsHigher body mass indexOlder ICU survivorsIntensive care unitBody mass indexFunctional recoveryICU survivorsICU admissionMass indexOlder Intensive Care Unit SurvivorsIntensive care unit survivorsOlder adultsPoor functional recoveryCritical illnessIndependent predictorsCare unitMultivariable analysisFunctional outcomePremorbid functionPotential predictorsVision impairmentAdmissionSurvivorsAnalytic sampleFunctional activityMonthsQuantifying the Severity of a Delirium Episode Throughout Hospitalization: the Combined Importance of Intensity and Duration
Vasunilashorn SM, Marcantonio ER, Gou Y, Pisani MA, Travison TG, Schmitt EM, Jones RN, Inouye SK. Quantifying the Severity of a Delirium Episode Throughout Hospitalization: the Combined Importance of Intensity and Duration. Journal Of General Internal Medicine 2016, 31: 1164-1171. PMID: 27259291, PMCID: PMC5023588, DOI: 10.1007/s11606-016-3671-9.Peer-Reviewed Original ResearchConceptsPost-hospital outcomesDelirium intensitySeverity measuresEpisode of deliriumPoor clinical outcomeDelirium durationDelirium episodesEntire hospitalizationAdult patientsClinical outcomesDelirium severityRelative riskIndependent cohortDeliriumStrong associationOutcomesHospitalizationCognitive changesDurationSeverityPredictive validityEpisodesAssociationCombined importancePatientsContinuation Rate of Atypical Antipsychotics After Discharge When Initiated in the Intensive Care Unit
Farrokh S, Castle AC, Heavner M, Pisani MA. Continuation Rate of Atypical Antipsychotics After Discharge When Initiated in the Intensive Care Unit. Journal Of Pharmacy Practice 2016, 30: 342-346. PMID: 27129913, DOI: 10.1177/0897190016645026.Peer-Reviewed Original ResearchConceptsIntensive care unitAtypical antipsychoticsHospital dischargeCare unitSafety outcomesLarge tertiary academic medical centerTertiary academic medical centerFinal study populationAcademic medical centerICU stayLack of evidenceCritical illnessMedical chartsQTc prolongationExtended therapyContinuation ratesInappropriate continuationMedical CenterStudy populationAntipsychoticsExclusion criteriaPhysician documentationPatientsProgress notesOutcomesEndobronchial Ultrasound-Guided Cautery-Assisted Transbronchial Forceps Biopsies: Safety and Sensitivity Relative to Transbronchial Needle Aspiration
Bramley K, Pisani MA, Murphy TE, Araujo KL, Homer RJ, Puchalski JT. Endobronchial Ultrasound-Guided Cautery-Assisted Transbronchial Forceps Biopsies: Safety and Sensitivity Relative to Transbronchial Needle Aspiration. The Annals Of Thoracic Surgery 2016, 101: 1870-1876. PMID: 26912301, PMCID: PMC4861078, DOI: 10.1016/j.athoracsur.2015.11.051.Peer-Reviewed Original ResearchConceptsTransbronchial needle aspirationTransbronchial forceps biopsyForceps biopsyClinical trialsEndobronchial ultrasoundNeedle aspirationConvex probe EBUSSignificant adverse eventsDiagnosis of sarcoidosisExcellent diagnostic yieldSelect clinical scenariosSequential useTBNA samplesSecondary outcomesUnselected patientsAdverse eventsLymph nodesThoracic lymphadenopathyEBUS guidanceGranulomatous inflammationCore biopsyGranulomatous diseaseAdequate specimensNeedle biopsyDiagnostic yield
2015
The Impact of Race on Intensity of Care Provided to Older Adults in the Medical Intensive Care Unit
Chima-Melton C, Murphy TE, Araujo KL, Pisani MA. The Impact of Race on Intensity of Care Provided to Older Adults in the Medical Intensive Care Unit. Journal Of Racial And Ethnic Health Disparities 2015, 3: 365-372. PMID: 27271078, PMCID: PMC4902115, DOI: 10.1007/s40615-015-0162-3.Peer-Reviewed Original ResearchConceptsMedical intensive care unitIntensive care unitIntensity of careTISS-28 scoresCare unitMICU interventionWhite patientsTherapeutic Intervention Scoring System-28Older adultsImpact of raceNew-onset dialysisRenal replacement therapyNon-white patientsPulmonary artery catheterizationBackgroundAfrican-AmericansICU mortalityAggressive carePrimary outcomeArtery catheterizationMechanical ventilationProspective studyReplacement therapyMore dementiaPatient preferencesChronic diseasesAssociation of Cumulative Dose of Haloperidol With Next-Day Delirium in Older Medical ICU Patients*
Pisani MA, Araujo KL, Murphy TE. Association of Cumulative Dose of Haloperidol With Next-Day Delirium in Older Medical ICU Patients*. Critical Care Medicine 2015, 43: 996-1002. PMID: 25746748, PMCID: PMC4400211, DOI: 10.1097/ccm.0000000000000863.Peer-Reviewed Original ResearchConceptsMedical ICU patientsNext-day deliriumTime-dependent confoundingICU patientsCumulative doseMedical ICUNonintubated patientsOdds ratioConfusion Assessment MethodTreatment of deliriumDose of haloperidolAge 60 yearsEfficacy of haloperidolRoute of administrationAcademic medical centerImportant clinical covariatesICU stayIntubated patientsClinical covariatesObservational studyHigher oddsMedical CenterDeliriumPatientsHaloperidolMortality among patients with pleural effusion undergoing thoracentesis
DeBiasi EM, Pisani MA, Murphy TE, Araujo K, Kookoolis A, Argento AC, Puchalski J. Mortality among patients with pleural effusion undergoing thoracentesis. European Respiratory Journal 2015, 46: 495-502. PMID: 25837039, PMCID: PMC4857137, DOI: 10.1183/09031936.00217114.Peer-Reviewed Original ResearchConceptsCongestive heart failurePleural effusionRenal failureHeart failureBenign etiologyMalignant effusionsHigh mortalityBilateral pleural effusionLong-term mortalityMortality of patientsProspective cohort studyMalignant pleural effusionBaseline characteristicsChart reviewCohort studyNonmalignant effusionsPoor prognosisHigh riskPatientsEffusionStandardised criteriaThoracentesisMortalityEtiologyFailureFunctional Trajectories Among Older Persons Before and After Critical Illness
Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Functional Trajectories Among Older Persons Before and After Critical Illness. JAMA Internal Medicine 2015, 175: 523-529. PMID: 25665067, PMCID: PMC4467795, DOI: 10.1001/jamainternmed.2014.7889.Peer-Reviewed Original ResearchConceptsIntensive care unitLong-term mortalityCritical illnessICU admissionModerate disabilityOlder personsMinimal disabilitySevere disabilityFunctional trajectoriesFunctional declineEarly deathProspective cohort studyDay of admissionPersons 70 yearsGoals of careRisk of deathShort-term mortalityGreater New HavenSignificant functional declineICU lengthCohort studyHospital dischargePremorbid disabilityCare unitMechanical ventilationSleep in the Intensive Care Unit
Pisani MA, Friese RS, Gehlbach BK, Schwab RJ, Weinhouse GL, Jones SF. Sleep in the Intensive Care Unit. American Journal Of Respiratory And Critical Care Medicine 2015, 191: 731-738. PMID: 25594808, PMCID: PMC5447310, DOI: 10.1164/rccm.201411-2099ci.Peer-Reviewed Original ResearchConceptsCritical illnessIntensive care unit patientsConcise clinical reviewCare unit patientsIntensive care unitPatient care activitiesCircadian rhythm abnormalitiesCircadian rhythmImportant physiologic processesLack of sleepUnit patientsICU patientsPatients' sleepCare unitClinical reviewAdverse outcomesSleep disturbancesRhythm abnormalitiesRole sleepCare activitiesIllnessClinical researchSleepPatientsPhysiologic processes
2014
Functional status after critical illness: agreement between patient and proxy assessments
Ahasic AM, Van Ness PH, Murphy TE, Araujo KL, Pisani MA. Functional status after critical illness: agreement between patient and proxy assessments. Age And Ageing 2014, 44: 506-510. PMID: 25324334, PMCID: PMC4411220, DOI: 10.1093/ageing/afu163.Peer-Reviewed Original ResearchConceptsMonths post-ICU dischargePost-ICU dischargeFunctional statusCritical illnessInter-observer agreementICU admissionOlder patientsExact testIntensive care unit admissionProxy assessmentsPremorbid functional statusCare unit admissionBaseline functional statusCurrent functional statusMcNemar's exact testUnit admissionICU dischargeMedical ICUNeuropsychological morbidityInstrumental ADLCognitive dysfunctionDaily livingPatientsCognitive impairmentParent cohortFeasibility study of unattended polysomnography in medical intensive care unit patients
Knauert MP, Yaggi HK, Redeker NS, Murphy TE, Araujo KL, Pisani MA. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart & Lung 2014, 43: 445-452. PMID: 25023504, PMCID: PMC4150840, DOI: 10.1016/j.hrtlng.2014.06.049.Peer-Reviewed Original ResearchConceptsMedical intensive care unitPortable polysomnographySleep efficiencyMedical intensive care unit patientsIntensive care unit patientsSleep deprivationOvernight sleep durationCare unit patientsObservational pilot studyIntensive care unitIndicators of feasibilityUnattended polysomnographyUnit patientsIll patientsPatients' sleepCare unitArousal indexPSG studiesSleep durationPatientsInterpretable qualityPilot studyGold standardSleepSleep stagesAdvanced Diagnostic Bronchoscopy Using Conscious Sedation and the Laryngeal Nerve Block: Tolerability, Thoroughness, and Diagnostic Yield
Goyal G, Pisani MA, Murphy TE, Araujo KL, Puchalski JT. Advanced Diagnostic Bronchoscopy Using Conscious Sedation and the Laryngeal Nerve Block: Tolerability, Thoroughness, and Diagnostic Yield. Lung 2014, 192: 905-913. PMID: 24972639, PMCID: PMC5417331, DOI: 10.1007/s00408-014-9607-4.Peer-Reviewed Original ResearchConceptsEndobronchial ultrasound-guided transbronchial needle aspirationConscious sedationDiagnostic bronchoscopic proceduresDiagnostic yieldPatient tolerabilityBronchoscopic proceduresUltrasound-guided transbronchial needle aspirationOccurrence of complicationsDosage of medicationAmount of medicationTransbronchial needle aspirationElectromagnetic navigational bronchoscopyAdvanced diagnostic bronchoscopySedation reversalSecondary outcomesPrimary outcomeNerve blockTransbronchial biopsyGeneral anesthesiaParenchymal abnormalitiesConventional bronchoscopyDiagnostic bronchoscopyResultsA totalAdditional biopsiesNeedle aspirationThe prevalence of undiagnosed diabetes mellitus and the association of baseline glycemic control on mortality in the intensive care unit: A prospective observational study
Hoang QN, Pisani MA, Inzucchi S, Hu B, Honiden S. The prevalence of undiagnosed diabetes mellitus and the association of baseline glycemic control on mortality in the intensive care unit: A prospective observational study. Journal Of Critical Care 2014, 29: 1052-1056. PMID: 25092614, DOI: 10.1016/j.jcrc.2014.06.007.Peer-Reviewed Original ResearchConceptsBaseline glycemic controlStress hyperglycemiaGlycemic controlUndiagnosed diabetesChronic Health Evaluation II scoreMedical intensive care unit patientsIntensive care unit patientsHemoglobin A1c levelsHistory of diabetesObservational cohort studyProspective observational studyUndiagnosed diabetes mellitusCare unit patientsIntensive care unitLower baseline HbA1cMultivariable logistic regressionSignificant differencesAcute PhysiologyHospital mortalityNondiabetic patientsBaseline HbA1cII scoreMICU patientsCohort studyCritical illnessMKK3 regulates mitochondrial biogenesis and mitophagy in sepsis-induced lung injury
Mannam P, Shinn AS, Srivastava A, Neamu RF, Walker WE, Bohanon M, Merkel J, Kang MJ, Dela Cruz CS, Ahasic AM, Pisani MA, Trentalange M, West AP, Shadel GS, Elias JA, Lee PJ. MKK3 regulates mitochondrial biogenesis and mitophagy in sepsis-induced lung injury. American Journal Of Physiology - Lung Cellular And Molecular Physiology 2014, 306: l604-l619. PMID: 24487387, PMCID: PMC3962628, DOI: 10.1152/ajplung.00272.2013.Peer-Reviewed Original ResearchConceptsSepsis-induced lung injuryPeripheral blood mononuclear cellsPrimary mouse lung endothelial cellsLethality of sepsisLevels of lungSystemic inflammatory responsePathogenesis of sepsisBlood mononuclear cellsCurrent medical careEffective therapeutic strategyRelevant animal modelsMitochondrial functionLung endothelial cellsNew diagnostic markersMitochondrial biogenesisAction of SIRT1Mouse lung endothelial cellsLung injurySeptic patientsNonseptic controlsMononuclear cellsSpecific therapyInflammatory responseSepsisTherapeutic strategies
2013
Patterns of Opiate, Benzodiazepine, and Antipsychotic Drug Dosing in Older Patients in a Medical Intensive Care Unit
Pisani MA, Bramley K, Vest MT, Akgün KM, Araujo KL, Murphy TE. Patterns of Opiate, Benzodiazepine, and Antipsychotic Drug Dosing in Older Patients in a Medical Intensive Care Unit. American Journal Of Critical Care 2013, 22: e62-e69. PMID: 23996429, PMCID: PMC4309662, DOI: 10.4037/ajcc2013835.Peer-Reviewed Original ResearchConceptsMedical intensive care unitIntensive care unitOlder patientsCare unitNursing shiftsHigh dosesEvening shiftsNight shiftsYale-New Haven HospitalEvening nursing shiftsPatients 60 yearsRoute of administrationImportant clinical covariatesMean ageClinical covariatesPsychoactive medicationsDrug dosingRandom effects Poisson modelDose levelsPatientsHaloperidolTotal dosesLorazepamSleep deprivationFentanylThe Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk
Puchalski JT, Argento AC, Murphy TE, Araujo KL, Pisani MA. The Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk. Annals Of The American Thoracic Society 2013, 10: 336-341. PMID: 23952852, PMCID: PMC3960907, DOI: 10.1513/annalsats.201210-088oc.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsBlood Coagulation DisordersClopidogrelCohort StudiesDrainageFemaleHepatic InsufficiencyHumansInternational Normalized RatioMaleMiddle AgedPlatelet Aggregation InhibitorsPleural EffusionPostoperative HemorrhageProspective StudiesRenal Insufficiency, ChronicRisk FactorsThrombocytopeniaTiclopidineWarfarinConceptsBleeding riskHematocrit levelsProspective observational cohort studySafety of thoracentesisWithholding of medicationsObservational cohort studyPotential bleeding riskElevated INRCohort studyRenal diseaseCommon etiologyPleural effusionRisk factorsObservational studyPatientsThoracentesisMedicationsHemothoraxTransfusionSignificant differencesRiskDiseasePhysiological factorsPhysiological parametersSafetyMedical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*
Akgün KM, Tate JP, Pisani M, Fried T, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Medical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*. Critical Care Medicine 2013, 41: 1458-1467. PMID: 23507717, PMCID: PMC4283206, DOI: 10.1097/ccm.0b013e31827caa46.Peer-Reviewed Original ResearchConceptsMedical ICU admissionVeterans Aging Cohort Study (VACS) IndexICU admissionAntiretroviral therapyRespiratory diagnosesMechanical ventilationVeterans Aging Cohort Study Index scoresUndetectable HIV-1 RNALogistic regressionStudy indicesVeterans Affairs Medical CenterCombination antiretroviral eraCritical care requirementsICU admission diagnosisMedical ICU careCombination antiretroviral therapyInfection/sepsisHIV-1 RNAHuman immunodeficiency virusMultivariable logistic regressionRoutine clinical biomarkersHigh mortality rateRevenue center codesAdmission diagnosisICU mortality
2012
Etiologies of bilateral pleural effusions
Puchalski JT, Argento AC, Murphy TE, Araujo KL, Oliva IB, Rubinowitz AN, Pisani MA. Etiologies of bilateral pleural effusions. Respiratory Medicine 2012, 107: 284-291. PMID: 23219348, PMCID: PMC5421548, DOI: 10.1016/j.rmed.2012.10.004.Peer-Reviewed Original ResearchConceptsRate of pneumothoraxBilateral thoracentesisExudative effusionsMalignant effusionsMultiple etiologiesCombination of etiologiesCommon single etiologyBilateral pleural effusionOutcomes of patientsOverall complication rateChest tube drainageProspective cohort studyCongestive heart failurePleural fluid characteristicsPleural fluid formationAcademic medical centerBilateral effusionsMore etiologiesMost effusionsCohort studyComplication rateTube drainageBilateral proceduresConsecutive patientsHeart failure