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
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 cohort
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
Epidemiology 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 studies
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
2007
Mechanical Ventilation and Acute Respiratory Distress Syndrome in Older Patients
Siner JM, Pisani MA. Mechanical Ventilation and Acute Respiratory Distress Syndrome in Older Patients. Clinics In Chest Medicine 2007, 28: 783-791. PMID: 17967294, DOI: 10.1016/j.ccm.2007.08.008.BooksConceptsAcute respiratory distress syndromeRespiratory distress syndromeDistress syndromeMechanical ventilationAcute respiratory failureAcute lung injuryIntensive care unitUnited States agesRespiratory failureLung injuryOlder patientsCare unitFunctional outcomeIncidence rateRespiratory functionAge-specific changesElderly adultsPatient careRespiratory systemSyndromeStates agesAgeVentilationARDSPatientsCharacteristics 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
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
Cognitive impairment in the intensive care unit
Pisani MA, McNicoll L, Inouye SK. Cognitive impairment in the intensive care unit. Clinics In Chest Medicine 2003, 24: 727-737. PMID: 14710700, DOI: 10.1016/s0272-5231(03)00092-3.Peer-Reviewed Original ResearchConceptsPre-existing cognitive impairmentCognitive impairmentICU stayICU settingRisk factorsPost-ICU stayRate of deliriumDevelopment of deliriumIntensive care unitPsychoactive medication usePersistence of deliriumDelirium preventionDelirium ratesMedical ICUOlder patientsFrequent complicationMedication useCare unitHigh prevalenceDeliriumICUOlder personsStayImpairmentPatientsDelirium 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