2016
Quantifying 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 notesOutcomesUse of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients
Han L, Pisani MA, Araujo KL, Allore HG. Use of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients. International Journal Of Statistics In Medical Research 2016, 5: 8-16. PMID: 27123153, PMCID: PMC4844076, DOI: 10.6000/1929-6029.2016.05.01.2.Peer-Reviewed Original ResearchDelirium severity scoresIntensive care unitSeverity scoreOld intensive care patientsIntensive care patientsOlder medical patientsDose of haloperidolStable patient characteristicsICU stayBaseline characteristicsAcute outcomesPatient characteristicsCare patientsCare unitMeasures of exposureMedical patientsAntipsychotic medicationFull cohortPatientsStable baselineAnalytic sampleTreatment effectsHaloperidolCohortScores
2015
Sedation in Critically Ill Patients
Oldham M, Pisani MA. Sedation in Critically Ill Patients. Critical Care Clinics 2015, 31: 563-587. PMID: 26118921, DOI: 10.1016/j.ccc.2015.03.010.Peer-Reviewed Original ResearchSleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit
Knauert MP, Haspel JA, Pisani MA. Sleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit. Clinics In Chest Medicine 2015, 36: 419-429. PMID: 26304279, DOI: 10.1016/j.ccm.2015.05.008.BooksConceptsCritical illnessSleep disruptionAppropriate administrative supportIntensive care unit environmentIntensive care unitCircadian rhythm disruptionDelirium reductionIll patientsCare unitPharmacologic interventionsSleep disturbancesRhythm disruptionCare deliveryMultidisciplinary strategyUnit environmentSleep lossIllnessDisruptionPatientsEffective strategySleepEnvironmental factorsAssociation 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 criteriaThoracentesisMortalityEtiologyFailureSleep 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 stagesMortality of Hospitalized Patients with Pleural Effusions
Kookoolis AS, Puchalski JT, Murphy TE, Araujo KL, Pisani MA. Mortality of Hospitalized Patients with Pleural Effusions. Journal Of Pulmonary & Respiratory Medicine 2014, 4: 184. PMID: 25977841, PMCID: PMC4428160, DOI: 10.4172/2161-105x.1000184.Peer-Reviewed Original ResearchSeverity of illnessShort-term survival benefitPleural effusionSurvival benefitPulmonary diseaseYale-New Haven HospitalTerm survival benefitMedical servicesCause mortalityHazard ratioHospital admissionHospitalized patientsMedical patientsMalignant effusionsMedical recordsMedical populationsProtective effectHigh riskPatientsEffusionThoracentesesLarger studyMortalityIllnessOne-year
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 parametersSafety
2012
Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes
Pisani MA, Ferrante L. Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes. Evidence-Based Nursing 2012, 16: 81. PMID: 23171569, DOI: 10.1136/eb-2012-101054.Commentaries, Editorials and Letters"Short-Stay" Patients In The Intensive Care Unit: Characterizing Patient Acuity, Throughput, And Critical Care Resource Utilization
Mathews K, Jenq G, Siner J, Long E, Pisani M. "Short-Stay" Patients In The Intensive Care Unit: Characterizing Patient Acuity, Throughput, And Critical Care Resource Utilization. 2012, a6731-a6731. DOI: 10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6731.Peer-Reviewed Original ResearchEpidemiology and Management of Common Pulmonary Diseases in Older Persons
Akgün KM, Crothers K, Pisani M. Epidemiology and Management of Common Pulmonary Diseases in Older Persons. The Journals Of Gerontology Series A 2012, 67A: 276-291. PMID: 22337938, PMCID: PMC3297767, DOI: 10.1093/gerona/glr251.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdenocarcinoma of LungAgedAged, 80 and overAnti-Bacterial AgentsAnti-Inflammatory AgentsAntineoplastic AgentsAsthmaFemaleHumansIdiopathic Pulmonary FibrosisIncidenceLung DiseasesLung NeoplasmsMalePneumoniaPrevalencePulmonary Disease, Chronic ObstructiveRisk FactorsTreatment OutcomeConceptsOlder patientsPulmonary diseaseCommon pulmonary diseasesQuality of lifePulmonary symptomsChronic obstructive pulmonary diseaseCommon clinical presentationObstructive pulmonary diseaseIdiopathic pulmonary fibrosisCommon pulmonary disordersMedical comorbiditiesClinical presentationPulmonary fibrosisLung cancerMultiple etiologiesPulmonary disordersRisk factorsPrevalence increasesDisease prevalence increasesPatientsOlder personsDiseaseMortalityDyspneaComorbidities
2011
Pulmonary Embolism in Older Patients
Mathur A, Sauler M, Pisani M. Pulmonary Embolism in Older Patients. Respiratory Medicine 2011, 133-153. DOI: 10.1007/978-1-60761-727-3_7.ChaptersVenous thromboembolic diseaseDeep vein thrombosisPulmonary embolismThromboembolic diseaseComplications of treatmentMiddle-aged subjectsHospital deathOlder patientsVein thrombosisSignificant morbidityGeriatric populationRisk factorsMedical conditionsEmbolismPatientsDiseaseDiagnosisDeathAgeTreatmentMorbidityThrombosisComplicationsPathophysiologyMajor studiesCritical Illness in HIV-Infected Patients in the Era of Combination Antiretroviral Therapy
Akgün KM, Huang L, Morris A, Justice AC, Pisani M, Crothers K. Critical Illness in HIV-Infected Patients in the Era of Combination Antiretroviral Therapy. Annals Of The American Thoracic Society 2011, 8: 301-307. PMID: 21653532, PMCID: PMC3132789, DOI: 10.1513/pats.201009-060wr.Peer-Reviewed Original ResearchConceptsCombination antiretroviral therapyAntiretroviral therapyICU admissionCritical illnessAdministration of ARTImpact of ARTProportion of deathsHIV eraOpportunistic infectionsHIVAIDS epidemicMore recent studiesIllnessPatientsAdmissionTherapyRecent studiesICUEtiologyInfectionMortalityIncidenceDiseaseAdministration
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 65SepsisDelirium assessment in the intensive care unit: patient population matters
Pisani MA. Delirium assessment in the intensive care unit: patient population matters. Critical Care 2008, 12: 131. PMID: 18423059, PMCID: PMC2447584, DOI: 10.1186/cc6847.Peer-Reviewed Original Research