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 activityMonthsPerceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers
Kamdar BB, Knauert MP, Jones SF, Parsons EC, Parthasarathy S, Pisani MA. Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers. Annals Of The American Thoracic Society 2016, 13: 1370-7. PMID: 27104770, PMCID: PMC5021080, DOI: 10.1513/annalsats.201601-087oc.Peer-Reviewed Original ResearchConceptsPoor sleepICU outcomesProviders' perceptionsIntensive care unit outcomesAvailable evidence-based guidelinesDevelopment of deliriumIntensive care unitEvidence-based guidelinesCritical care providersBetter sleep qualityMinority of providersICU surveyICU patientsIll patientsCare unitMechanical ventilationICU providersPatient outcomesRecent guidelinesPhysical therapyMost cliniciansPromotion protocolSleep qualityCare providersICUComparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales
Knauert M, Jeon S, Murphy TE, Yaggi HK, Pisani MA, Redeker NS. Comparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales. Journal Of Critical Care 2016, 36: 1-7. PMID: 27546739, PMCID: PMC5097003, DOI: 10.1016/j.jcrc.2016.06.005.Peer-Reviewed Original ResearchConceptsIntensive care unitMedical intensive care unitCare unitWorld Health Organization recommendationsProspective observational studyICU patient roomsIllness severityPatient factorsMechanical ventilationObservational studyPeak occurrenceICU environmentSignificant discordanceCircadian disruptionPatient roomsDecibel scaleSound levelsEquivalent sound levelPeak measuresDeliriumLevelsMeaningful factorsSleepLow-frequency soundAverage levelQuantifying 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 yieldComparison of Transbronchial and Cryobiopsies in Evaluation of Diffuse Parenchymal Lung Disease
Ramaswamy A, Homer R, Killam J, Pisani MA, Murphy TE, Araujo K, Puchalski J. Comparison of Transbronchial and Cryobiopsies in Evaluation of Diffuse Parenchymal Lung Disease. Journal Of Bronchology & Interventional Pulmonology 2016, 23: 14-21. PMID: 26705007, PMCID: PMC4864578, DOI: 10.1097/lbr.0000000000000246.Peer-Reviewed Original ResearchConceptsDiffuse parenchymal lung diseaseTransbronchial lung cryobiopsyTransbronchial lung biopsyParenchymal lung diseaseLung diseaseFlexible bronchoscopyDiagnostic yieldTertiary care academic centerVideo-assisted thoracoscopic surgeryInterstitial lung diseaseHigh diagnostic yieldTBLB specimensLung biopsyLung cryobiopsyMassive hemoptysisPrior malignancyThoracoscopic surgeryClinicopathologic featuresHypersensitivity pneumonitisModerate sedationRetrospective studyTherapeutic optionsMean ageFinal diagnosisPostprocedural outcomes
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 COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans
Attia EF, McGinnis KA, Feemster LC, Akgün KM, Butt AA, Graber CJ, Fine MJ, Goetz MB, Rodriguez-Barradas MC, Pisani MA, Tindle HA, Brown ST, Hoo G, Rimland D, Gibert CL, Huang L, Freiberg MS, Hough CL, Crothers K. Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 70: 280-288. PMID: 26181820, PMCID: PMC4607625, DOI: 10.1097/qai.0000000000000751.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseCommunity-acquired pneumoniaPneumocystis jirovecii pneumoniaIndependent risk factorIncidence rate ratiosPulmonary infectionRisk factorsAssociation of COPDBurden of COPDVeterans Aging Cohort Study Virtual CohortRisk of CAPMultivariable Poisson regression modelsBaseline comorbid conditionsDifferent pulmonary infectionsInfections Requiring HospitalizationCD4 cell countHIV viral loadChronic lung diseaseObstructive pulmonary diseaseMultivariable Poisson regressionUnadjusted incidence rateNinth Revision codesPoisson regression modelsJirovecii pneumoniaPulmonary tuberculosisThe 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 diseasesComparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Barakat LA, Juthani-Mehta M, Allore H, Trentalange M, Tate J, Rimland D, Pisani M, Akgün KM, Goetz MB, Butt AA, Rodriguez-Barradas M, Duggal M, Crothers K, Justice AC, Quagliarello VJ. Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia. HIV Medicine 2015, 16: 421-430. PMID: 25959543, PMCID: PMC5015437, DOI: 10.1111/hiv.12244.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaVeterans Aging Cohort StudyVACS IndexCAP outcomesAntiretroviral therapyOlder adultsHigher VACS indexDays of dischargeAging Cohort StudyUninfected participantsCohort studyMean LOSHIV infectionLonger LOSClinical outcomesUnadjusted analysesUninfected groupMultivariable modelEligibility criteriaHIVMale veteransMortality rateART useMortalityOutcomesAssociation 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 processesHealth care worker attitudes and identified barriers to patient sleep in the medical intensive care unit
Hopper K, Fried TR, Pisani MA. Health care worker attitudes and identified barriers to patient sleep in the medical intensive care unit. Heart & Lung 2015, 44: 95-99. PMID: 25686516, PMCID: PMC5632814, DOI: 10.1016/j.hrtlng.2015.01.011.Peer-Reviewed Original ResearchConceptsHealth care workers' attitudesCare workers' attitudesPatients' sleepMedical intensive care unitIntensive care unit patientsCare unit patientsIntensive care unitSystem-based barriersSignificance of sleepICU careUnit patientsCare unitSleep promotionICU policyMultiple environmental barriersSleep disruptionQualitative studyICUSleepNight shiftsLack of consensusWorkers' attitudesAttitudinal barriersAdditional targetsEnvironmental barriers
2014
Feasibility 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 aspiration