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
2015
The authors reply
Murphy TE, Araujo KL, Pisani MA. The authors reply. Critical Care Medicine 2015, 43: e589-e590. PMID: 26575672, PMCID: PMC4686334, DOI: 10.1097/ccm.0000000000001342.Peer-Reviewed Original ResearchAssociation 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 CenterDeliriumPatientsHaloperidol
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 deprivationFentanyl
2012
ICU delirium
Jones SF, Pisani MA. ICU delirium. Current Opinion In Critical Care 2012, 18: 146-151. PMID: 22322260, DOI: 10.1097/mcc.0b013e32835132b9.Peer-Reviewed Original ResearchConceptsICU deliriumRisk factorsLong-term neurocognitive impairmentDelirium-related outcomesPreferred pharmacologic treatmentSignificant adverse outcomesUse of sedativesUse of protocolsPharmacologic treatmentAtypical antipsychoticsVentilator managementAdverse outcomesUnderdiagnosed problemDeliriumNeurocognitive impairmentSusceptible individualsAvailable evidenceRecent evidenceOutcomesLong-term impactTreatmentLimited studiesRobust evidenceNegative outcomesManagement
2010
Factors associated with persistent delirium after intensive care unit admission in an older medical patient population
Pisani MA, Murphy TE, Araujo KL, Van Ness PH. Factors associated with persistent delirium after intensive care unit admission in an older medical patient population. Journal Of Critical Care 2010, 25: 540.e1-540.e7. PMID: 20413252, PMCID: PMC2939229, DOI: 10.1016/j.jcrc.2010.02.009.Peer-Reviewed Original ResearchConceptsPersistent deliriumMedical intensive care unit populationIntensive care unit admissionIntensive care unit populationMultivariable logistic regression modelCare unit admissionConfusion Assessment MethodPatients 60 yearsProspective cohort studyUse of haloperidolUse of opioidsSeverity of illnessMedical patient populationLogistic regression modelsICU stayUnit admissionICU deliriumCohort studyPatient demographicsMedication dataPatient populationConsecutive admissionsCode statusDeliriumUnit population