2016
Comparing 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 level
2015
Awake or Sedated: Trends in the Evaluation and Management of Agitation in the Intensive Care Unit
DeBiasi EM, Akgün KM, Pisani M. Awake or Sedated: Trends in the Evaluation and Management of Agitation in the Intensive Care Unit. Seminars In Respiratory And Critical Care Medicine 2015, 36: 899-913. PMID: 26595050, DOI: 10.1055/s-0035-1564875.BooksConceptsICU patientsSedation practicesIll intensive care unit (ICU) patientsIntensive care unit patientsSedation assessment scaleMechanical ventilation durationCare unit patientsManagement of agitationMost ICU patientsIntensive care unitImproved clinical outcomesMultidisciplinary treatment modelLife-saving interventionsHospital lengthMinimal sedationSedative medicationsUnit patientsCare unitClinical outcomesMechanical ventilationVentilation durationPatient distressFunctional impairmentPractice guidelinesPatient discomfortThe 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 diseasesSleep 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 processesFunctional 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 ventilationHealth 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 ResearchMeSH KeywordsAttitude of Health PersonnelCritical CareFemaleHumansIntensive Care UnitsMaleNursesPhysiciansSleepConceptsHealth 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
2013
Risk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans
Akgün KM, Gordon K, Pisani M, Fried T, McGinnis KA, Tate JP, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Risk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2013, 62: 52-59. PMID: 23111572, PMCID: PMC4182723, DOI: 10.1097/qai.0b013e318278f3fa.Peer-Reviewed Original ResearchConceptsVACS Index scoreMedical intensive care unit admissionIntensive care unit admissionVeterans Aging Cohort StudyCare unit admissionMICU admissionIndex scoreRisk factorsHazardous alcohol useVACS IndexUnit admissionCurrent smokingChronic obstructive pulmonary diseaseAlcohol useNon-AIDS diseasesVA administrative databasesMultivariable Cox regressionSurvival of HIVObstructive pulmonary diseaseAging Cohort StudyElectronic medical recordsAntiretroviral therapyCause mortalityPrior AIDSPrior cancer
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
2011
Bayesian Time-Series Analysis of a Repeated-Measures Poisson Outcome With Excess Zeroes
Murphy TE, Van Ness PH, Araujo KL, Pisani MA. Bayesian Time-Series Analysis of a Repeated-Measures Poisson Outcome With Excess Zeroes. American Journal Of Epidemiology 2011, 174: 1230-1237. PMID: 22025357, PMCID: PMC3254157, DOI: 10.1093/aje/kwr252.Peer-Reviewed Original ResearchConceptsPosterior predictive simulationsExcess zerosBayesian modelBayesian time series analysisPredictive simulationsHierarchical Bayesian modelPoisson outcomesPosterior distributionTime series analysisBayesian frameworkRelated resultsStatistical factorsBayesian analysisRandom effects Poisson modelFrequentistZerosPoisson modelSmall samplesExcessive numberAutocorrelationSimulationsTime series techniquesModelPeriodicityMultivariate graphical methods provide an insightful way to formulate explanatory hypotheses from limited categorical data
Van Ness PH, Murphy TE, Araujo KL, Pisani MA. Multivariate graphical methods provide an insightful way to formulate explanatory hypotheses from limited categorical data. Journal Of Clinical Epidemiology 2011, 65: 179-188. PMID: 21889310, PMCID: PMC3250573, DOI: 10.1016/j.jclinepi.2011.06.007.Peer-Reviewed Original Research
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
2008
Analytic Reviews: Considerations in Caring for the Critically Ill Older Patient
Pisani MA. Analytic Reviews: Considerations in Caring for the Critically Ill Older Patient. Journal Of Intensive Care Medicine 2008, 24: 83-95. PMID: 19114416, DOI: 10.1177/0885066608329942.Peer-Reviewed Original ResearchConceptsOlder patientsPhysiologic changesOlder intensive care unit patientsIntensive care unit admissionIntensive care unit patientsIll Older PatientsImportant physiologic changesOlder ICU patientsCare unit admissionCare unit patientsDevelopment of sepsisSeverity of illnessUnit admissionCritical illnessUnit patientsICU patientsPoor outcomeAdverse outcomesRisk factorsCritical careOutcome studiesChronologic agePatientsAge 65Sepsis
2005
Short-term outcomes in older intensive care unit patients with dementia*
Pisani MA, Redlich CA, McNicoll L, Ely EW, Friedkin RJ, Inouye SK. Short-term outcomes in older intensive care unit patients with dementia*. Critical Care Medicine 2005, 33: 1371-1376. PMID: 15942358, DOI: 10.1097/01.ccm.0000165558.83676.48.Peer-Reviewed Original ResearchConceptsICU interventionsOlder patientsModerate-severe dementiaPatient ageCode statusMortality rateChronic Health Evaluation II scoreOlder intensive care unit patientsProspective observational cohort studyIntensive care unit careIntensive care unit patientsUrban university teaching hospitalShort-term mortality rateBlessed Dementia Rating ScaleHigher Acute PhysiologyHospital mortality rateObservational cohort studyCare unit patientsMedical record abstractionShort-term outcomesUniversity Teaching HospitalDementia Rating ScaleImpact of dementiaAcute PhysiologyHospital length
2003
Underrecognition of Preexisting Cognitive Impairment by Physicians in Older ICU Patients
Pisani MA, Redlich C, McNicoll L, Ely EW, Inouye SK. Underrecognition of Preexisting Cognitive Impairment by Physicians in Older ICU Patients. CHEST Journal 2003, 124: 2267-2274. PMID: 14665510, DOI: 10.1378/chest.124.6.2267.Peer-Reviewed Original ResearchConceptsOlder ICU patientsCognitive impairmentICU patientsPhysician recognitionUrban university teaching hospitalCross-sectional comparative studyBlessed Dementia Rating ScalePreexisting Cognitive ImpairmentIndependent risk factorMedical record abstractionUniversity Teaching HospitalCognitive impairment increasesDementia Rating ScaleMajority of casesMedical ICUPatient factorsRecord abstractionICU physiciansIntensive carePhysician interviewsRisk factorsTeaching hospitalSerious illnessICUInformant Questionnaire