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
Outcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit
Rowe T, Araujo KL, Van Ness PH, Pisani MA, Juthani-Mehta M. Outcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit. Open Forum Infectious Diseases 2016, 3: ofw010. PMID: 26925430, PMCID: PMC4766385, DOI: 10.1093/ofid/ofw010.Peer-Reviewed Original ResearchAssociation of sepsisICU admissionOlder adultsBaseline characteristicsSystemic inflammatory response syndrome criteriaIntensive care unit admissionCox proportional hazards modelImpact of sepsisCare unit admissionProspective cohort studyDiagnosis of sepsisDefinition of sepsisIntensive care unitMain outcome measuresProportional hazards modelUnit admissionSyndrome criteriaCohort studyCare unitOutcome measuresSepsisHazards modelAdmissionMortalityEarly use
2015
Comparing 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 useMortalityOutcomesMortality 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 ventilationPatient-Centered Outcomes Following Thoracentesis
Argento AC, Murphy TE, Pisani MA, Araujo KL, Puchalski J. Patient-Centered Outcomes Following Thoracentesis. PLEURA 2015, 2: 237399751560040. PMID: 26767192, PMCID: PMC4708257, DOI: 10.1177/2373997515600404.Peer-Reviewed Original ResearchPleural interventionsSustained improvementPleural effusionProspective observational cohort studyTertiary care academic medical centerAdditional pleural proceduresObservational cohort studyMajority of patientsShort Form-12Multivariable logistic regressionPatient-centered outcomesAcademic medical centerSignificant clinical impactAdult patientsCohort studyHepatic hydrothoraxSecondary outcomesDays postprocedureInfectious etiologyPrimary outcomeTherapeutic thoracentesisAnalytical cohortForm-12Significant morbidityIndex procedure
2014
The 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 illness
2013
The 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 parametersSafety
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
2011
Validating Smoking Data From the Veteran’s Affairs Health Factors Dataset, an Electronic Data Source
McGinnis KA, Brandt CA, Skanderson M, Justice AC, Shahrir S, Butt AA, Brown ST, Freiberg MS, Gibert CL, Goetz MB, Kim JW, Pisani MA, Rimland D, Rodriguez-Barradas MC, Sico JJ, Tindle HA, Crothers K. Validating Smoking Data From the Veteran’s Affairs Health Factors Dataset, an Electronic Data Source. Nicotine & Tobacco Research 2011, 13: 1233-1239. PMID: 21911825, PMCID: PMC3223583, DOI: 10.1093/ntr/ntr206.Peer-Reviewed Original ResearchConceptsSmoking statusHealth factorsSmoking dataKappa statisticsSmoking variablesVeterans Aging Cohort StudyAging Cohort StudySelf-reported smoking dataCohort studyCurrent smokersSmoking interventionsVirtual cohortElectronic data sourcesEMR dataFuture studiesStatusParticipantsFactorsHIVSmokersSmokingStudy surveyCohort
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
2009
Days of Delirium Are Associated with 1-Year Mortality in an Older Intensive Care Unit Population
Pisani MA, Kong SY, Kasl SV, Murphy TE, Araujo KL, Van Ness PH. Days of Delirium Are Associated with 1-Year Mortality in an Older Intensive Care Unit Population. American Journal Of Respiratory And Critical Care Medicine 2009, 180: 1092-1097. PMID: 19745202, PMCID: PMC2784414, DOI: 10.1164/rccm.200904-0537oc.Peer-Reviewed Original ResearchConceptsICU deliriumPatient populationNumber of daysOlder intensive care unit patientsIntensive care unit populationAdverse long-term outcomesIntensive care unit patientsRelevant covariatesUrban acute care hospitalDuration of deliriumPost-ICU admissionConfusion Assessment MethodOlder patient populationProspective cohort studyCare unit patientsSeverity of illnessLong-term outcomesDays of deliriumPsychoactive medication useAcute care hospitalsChart review methodImportant health outcomesICU admissionCohort studyICU populationBenzodiazepine and opioid use and the duration of intensive care unit delirium in an older population*
Pisani MA, Murphy TE, Araujo KL, Slattum P, Van Ness PH, Inouye SK. Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population*. Critical Care Medicine 2009, 37: 177-183. PMID: 19050611, PMCID: PMC2700732, DOI: 10.1097/ccm.0b013e318192fcf9.Peer-Reviewed Original ResearchConceptsModifiable risk factorsICU deliriumDelirium durationOpioid useRisk factorsFirst episodeMedical intensive care unit patientsIntensive care unit deliriumMedical intensive care unitIntensive care unit patientsUrban university teaching hospitalConfusion Assessment MethodProspective cohort studyCare unit patientsSeverity of illnessIntensive care unitUniversity Teaching HospitalMain outcome measuresUse of benzodiazepinesChart review methodMultivariable regression modelsImpact of benzodiazepinesCohort studyMedian durationUnit patients
2007
Characteristics Associated With Delirium in Older Patients in a Medical Intensive Care Unit
Pisani MA, Murphy TE, Van Ness PH, Araujo KL, Inouye SK. Characteristics Associated With Delirium in Older Patients in a Medical Intensive Care Unit. JAMA Internal Medicine 2007, 167: 1629-1634. PMID: 17698685, DOI: 10.1001/archinte.167.15.1629.Peer-Reviewed Original ResearchConceptsAdmission risk factorsMedical record reviewIntensive care unitICU admissionRisk factorsOlder patientsRecord reviewCare unitMedical intensive care unitUrban university teaching hospitalOlder ICU patientsReceipt of benzodiazepinesConfusion Assessment MethodPatients 60 yearsProspective cohort studyLower arterial pHUniversity Teaching HospitalMain outcome measuresMultivariate logistic regressionDelirium durationICU deliriumCohort studyCreatinine levelsICU patientsArterial pH
2006
A research algorithm to improve detection of delirium in the intensive care unit
Pisani MA, Araujo K, Van Ness PH, Zhang Y, Ely E, Inouye SK. A research algorithm to improve detection of delirium in the intensive care unit. Critical Care 2006, 10: r121. PMID: 16919169, PMCID: PMC1750978, DOI: 10.1186/cc5027.Peer-Reviewed Original ResearchConceptsIntensive care unitDetection of deliriumCAM-ICUChart review methodCohort studyCare unitClinical careMedical intensive care unitDelirium instrumentCAM-ICU ratingsChart-based reviewIll ICU patientsPrevalence of deliriumConfusion Assessment MethodProspective cohort studyResearch settingsDelirium statusChart reviewICU patientsDeliriumDelirium researchPatientsChart-based methodPatient safetyDiagnostic accuracy
2003
Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients
McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients. Journal Of The American Geriatrics Society 2003, 51: 591-598. PMID: 12752832, DOI: 10.1034/j.1600-0579.2003.00201.x.Peer-Reviewed Original ResearchConceptsConfusion Assessment MethodOccurrence of deliriumPost-ICU periodICU stayMedical intensive care unit patientsIntensive care unit patientsOlder ICU patientsDevelopment of deliriumHalf of patientsProspective cohort studyCare unit patientsMedical chart reviewNormal mental statusBaseline functional statusSeverity of illnessIntensive care unitUniversity Teaching HospitalSurrogate interviewsHospital stayBaseline characteristicsChart reviewCohort studyFrequent complicationMedical ICUOlder patients