2024
Early Warning Scores With and Without Artificial Intelligence
Edelson D, Churpek M, Carey K, Lin Z, Huang C, Siner J, Johnson J, Krumholz H, Rhodes D. Early Warning Scores With and Without Artificial Intelligence. JAMA Network Open 2024, 7: e2438986. PMID: 39405061, PMCID: PMC11544488, DOI: 10.1001/jamanetworkopen.2024.38986.Peer-Reviewed Original ResearchConceptsEarly Warning ScoreWarning ScoreCohort studyYale New Haven Health SystemClinical deterioration eventsHigh-risk thresholdHealth systemRetrospective cohort studyPatient encountersDeteriorating patientsOverall PPVMain OutcomesInpatient encountersEDI scoresHospital encountersDeterioration eventsClinical deteriorationIntensive care unitEarly warning toolCare unitDecision support toolArtificial intelligenceScoresReceiver operating characteristic curveNEWS2
2020
The Association Between Endotracheal Tube Size and Aspiration (During Flexible Endoscopic Evaluation of Swallowing) in Acute Respiratory Failure Survivors.
Krisciunas GP, Langmore SE, Gomez-Taborda S, Fink D, Levitt JE, McKeehan J, McNally E, Scheel R, Rubio AC, Siner JM, Vojnik R, Warner H, White SD, Moss M. The Association Between Endotracheal Tube Size and Aspiration (During Flexible Endoscopic Evaluation of Swallowing) in Acute Respiratory Failure Survivors. Critical Care Medicine 2020, 48: 1604-1611. PMID: 32804785, PMCID: PMC7644217, DOI: 10.1097/ccm.0000000000004554.Peer-Reviewed Original ResearchConceptsEndotracheal tube sizeFlexible endoscopic evaluationSilent aspirationEndoscopic evaluationMedical recordsEndotracheal tubeGranulation tissueAcademic tertiary care medical centerAcute respiratory failure survivorsTertiary care medical centerPenetration-Aspiration Scale scoresAcute respiratory failureModifiable risk factorsProspective cohort studyThird of patientsHours of extubationRisk of aspirationSmall endotracheal tubePatients' medical recordsHospital outcomesRespiratory failureCohort studyPatient demographicsSwallowing examinationMultivariable analysisEndotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study
Goshua G, Pine AB, Meizlish ML, Chang CH, Zhang H, Bahel P, Baluha A, Bar N, Bona RD, Burns AJ, Dela Cruz CS, Dumont A, Halene S, Hwa J, Koff J, Menninger H, Neparidze N, Price C, Siner JM, Tormey C, Rinder HM, Chun HJ, Lee AI. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. The Lancet Haematology 2020, 7: e575-e582. PMID: 32619411, PMCID: PMC7326446, DOI: 10.1016/s2352-3026(20)30216-7.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBetacoronavirusBiomarkersBlood Coagulation DisordersCoronavirus InfectionsCOVID-19Critical IllnessCross-Sectional StudiesEndothelium, VascularFemaleFollow-Up StudiesHumansIntensive Care UnitsMaleMiddle AgedPandemicsPneumonia, ViralPrognosisSARS-CoV-2Vascular DiseasesYoung AdultConceptsCOVID-19-associated coagulopathyNon-ICU patientsIntensive care unitKaplan-Meier analysisSoluble P-selectinCross-sectional studyPlatelet activationHospital dischargeICU patientsSoluble thrombomodulinEndothelial cellsVWF antigenCOVID-19P-selectinSingle-center cross-sectional studyLaboratory-confirmed COVID-19Medical intensive care unitSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesisVon Willebrand factor antigenSoluble thrombomodulin concentrationsVWF antigen concentrationEndothelial cell injurySoluble CD40 ligandMicrovascular complicationsAdult patients
2019
Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?
Leder SB, Warner HL, Suiter DM, Young NO, Bhattacharya B, Siner JM, Davis KA, Maerz LL, Rosenbaum SH, Marshall PS, Pisani MA, Siegel MD, Brennan JJ, Schuster KM. Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours? Annals Of Otology Rhinology & Laryngology 2019, 128: 619-624. PMID: 30841709, DOI: 10.1177/0003489419836115.Peer-Reviewed Original ResearchConceptsIntensive care unitSwallow evaluationDifferent intensive care unitsRe-intubation rateYale Swallow ProtocolMajority of patientsPost-extubation dysphagiaIntubation durationNosocomial pneumoniaPost extubationLonger hospitalizationCare unitProspective InvestigationSwallow ProtocolSwallowingHoursDysphagiaHospitalizationIntubationPneumoniaPatientsIncidenceEvaluation
2016
“Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients
Sankey CB, McAvay G, Siner JM, Barsky CL, Chaudhry SI. “Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients. Journal Of General Internal Medicine 2016, 31: 895-900. PMID: 26969311, PMCID: PMC4945556, DOI: 10.1007/s11606-016-3654-x.Peer-Reviewed Original ResearchConceptsMedical intensive care unitEscalation of careIntensive care unitClinical deteriorationCare escalationHospitalized patientsCare unitDoor timeInpatient medicineRetrospective cohort studySeverity of illnessRisk of deathAcademic medical centerHospital mortalityICU transferCohort studyInpatient floorInpatient settingMedical CenterGeneral floorPatientsCareMortalityCurrent eraPrevious studies
2015
Protocol-Based Care versus Individualized Management of Patients in the Intensive Care Unit
Siner JM, Connors GR. Protocol-Based Care versus Individualized Management of Patients in the Intensive Care Unit. Seminars In Respiratory And Critical Care Medicine 2015, 36: 870-877. PMID: 26595047, DOI: 10.1055/s-0035-1566157.BooksConceptsIntensive care unitCare unitGeneral practiceEvidence-based careStandard of careHealth care deliveryIndividualized managementPhysicians' concernsHigh-acuity environmentCare deliveryMedical careCareLoss of autonomyCare placesCorrect interventionCorrect careComplete penetranceMedical traineesUniform practiceConsistent practiceDeliveryPatientsHospitalAimBest protocolOral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula
Leder SB, Siner JM, Bizzarro MJ, McGinley BM, Lefton-Greif MA. Oral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula. Dysphagia 2015, 31: 154-159. PMID: 26590570, DOI: 10.1007/s00455-015-9669-3.Peer-Reviewed Original ResearchConceptsOral alimentationOral feedingNasal cannulaMedical conditionsIntensive care unit settingPatient-specific determinantsAdult ICU patientsHigh-flow oxygenUnderlying medical conditionsFunctional swallowSwallow testingAdult patientsCohort studyRespiratory supportICU patientsICU inpatientsFlow oxygenUnit settingRespiratory issuesPatientsAdult populationHigh acuityParticipant characteristicsSuccessful resumptionAlimentationProtocols and Hospital Mortality in Critically Ill Patients
Sevransky JE, Checkley W, Herrera P, Pickering BW, Barr J, Brown SM, Chang SY, Chong D, Kaufman D, Fremont RD, Girard TD, Hoag J, Johnson SB, Kerlin MP, Liebler J, O’Brien J, O’Keefe T, Park PK, Pastores SM, Patil N, Pietropaoli AP, Putman M, Rice TW, Rotello L, Siner J, Sajid S, Murphy DJ, Martin GS. Protocols and Hospital Mortality in Critically Ill Patients. Critical Care Medicine 2015, 43: 2076-2084. PMID: 26110488, PMCID: PMC5673100, DOI: 10.1097/ccm.0000000000001157.Peer-Reviewed Original ResearchConceptsHospital mortalityIll patientsProtocol complianceClinical protocolsUnited States Critical IllnessAcute respiratory distress syndromeSpontaneous breathing trialLung-protective ventilationRespiratory distress syndromeLength of stayComplete outcome dataPatients 1 dayVentilator management protocolsSuperior patient outcomesLack of associationSingle variable analysisDesirable therapyBreathing trialProtective ventilationCritical illnessDistress syndromeICU protocolPrimary outcomeMechanical ventilationMultivariable analysisClinical Reasoning and Risk in the Intensive Care Unit
Connors GR, Siner JM. Clinical Reasoning and Risk in the Intensive Care Unit. Clinics In Chest Medicine 2015, 36: 449-459. PMID: 26304282, DOI: 10.1016/j.ccm.2015.05.016.BooksAdverse Event Reporting and Quality Improvement in the Intensive Care Unit
Heavner JJ, Siner JM. Adverse Event Reporting and Quality Improvement in the Intensive Care Unit. Clinics In Chest Medicine 2015, 36: 461-467. PMID: 26304283, DOI: 10.1016/j.ccm.2015.05.005.BooksMeSH KeywordsAdverse Drug Reaction Reporting SystemsHumansIntensive Care UnitsPharmacovigilanceQuality ImprovementRisk Management
2014
Structure, Process, and Annual ICU Mortality Across 69 Centers
Checkley W, Martin GS, Brown SM, Chang SY, Dabbagh O, Fremont RD, Girard TD, Rice TW, Howell MD, Johnson SB, O’Brien J, Park PK, Pastores SM, Patil NT, Pietropaoli AP, Putman M, Rotello L, Siner J, Sajid S, Murphy DJ, Sevransky JE. Structure, Process, and Annual ICU Mortality Across 69 Centers. Critical Care Medicine 2014, 42: 344-356. PMID: 24145833, PMCID: PMC4035482, DOI: 10.1097/ccm.0b013e3182a275d7.Peer-Reviewed Original ResearchMeSH KeywordsAPACHECritical IllnessHospital MortalityHumansIntensive Care UnitsOutcome Assessment, Health CareProspective StudiesUnited StatesWounds and InjuriesConceptsChronic Health Evaluation IIICU mortalityProcess of careAcute PhysiologyUse of protocolsClinical outcomesNurse ratioEvaluation IICare reviewChronic Health Evaluation II scoreUnited States Critical IllnessAverage Acute PhysiologyHospital-level variationMultivariable linear regressionHouse intensivistICU statusIntensivist staffingMixed ICUII scoreCritical illnessMedical ICUSurgical ICUICU patientsIllness severityIntensivist coverage
2009
ELEVATED SERUM ANGIOPOIETIN 2 LEVELS ARE ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS
Siner JM, Bhandari V, Engle KM, Elias JA, Siegel MD. ELEVATED SERUM ANGIOPOIETIN 2 LEVELS ARE ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS. Shock 2009, 31: 348-353. PMID: 18791490, DOI: 10.1097/shk.0b013e318188bd06.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAngiopoietin-2APACHECritical CareFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedSepsisConceptsAng-2 levelsIntensive care unitAng-2Tertiary care medical intensive care unitProspective observational cohort studySerum Ang-2 levelsSerum angiopoietin-2 levelsMedical intensive care unitSerum Ang-2Observational cohort studyAngiopoietin-2 levelsIL-6 levelsHospital mortalityHuman sepsisICU admissionSevere sepsisCohort studyEndothelial dysfunctionHospital dischargeICU patientsIllness scoresSeptic shockCare unitIL-6Increased Mortality