Denise Acampora

Learn More
BACKGROUND Since in hospitalized older patients delirium is associated with poor outcomes, we evaluated the effectiveness of a multicomponent strategy for the prevention of delirium. METHODS We studied 852 patients 70 years of age or older who had been admitted to the general-medicine service at a teaching hospital. Patients from one intervention unit and(More)
To achieve more appropriate triage to the coronary care unit of patients presenting with acute chest pain, we used clinical data on 1379 patients at two hospitals to construct a simple computer protocol to predict the presence of myocardial infarction. When we tested this protocol prospectively in 4770 patients at two university hospitals and four community(More)
In a prospective multicenter investigation of emergency room patients with acute chest pain, physicians admitted 96% of patients with acute myocardial infarction (AMI) and discharged 4%. Of 35 patients who were sent home with AMI, only 11 (31%) returned to the same hospital because of persistent symptoms. Compared with a control group of 105 randomly(More)
OBJECTIVES The economic impact of trauma in older persons is a matter of increasing concern to public health practitioners and planners, yet it is an issue that has not been widely studied. Available evidence does suggest, however, that falls are the costliest category of injury among older persons. METHODS This study used data from the Health Care(More)
Myocardial infarction was diagnosed in 431 (30%) of 1460 patients with acute chest pain who had serial enzyme testing after admission to intensive or intermediate care units at three teaching and three community hospitals. The diagnosis was made within 12 hours of admission in 331 (77%) patients and within 24 hours in 415 (96%). Of the 16 patients with(More)
BACKGROUND Falling is a common and morbid condition among elderly persons. Effective strategies to prevent falls have been identified but are underutilized. METHODS Using a nonrandomized design, we compared rates of injuries from falls in a region of Connecticut where clinicians had been exposed to interventions to change clinical practice (intervention(More)
OBJECTIVE To determine whether a home-based systematic multicomponent rehabilitation strategy leads to improved outcomes relative to usual care. DESIGN A randomized controlled trial with 12 months of follow-up. SETTING General community; 27 home care agencies. PARTICIPANTS Three hundred four nondemented persons at least 65 years of age who underwent(More)
OBJECTIVES To report on the penetration of, and identified barriers to and facilitators of, efforts to incorporate evidence-based fall risk assessment and management into clinical practice throughout a defined geographic area. DESIGN Dissemination project. SETTING North central Connecticut. PARTICIPANTS Hospitals, home care agencies, primary care(More)
We studied the adequacy of antitetanus prophylaxis given to 620 patients with open soft-tissue injuries by 169 physicians in six hospital emergency rooms. Twenty-three per cent of the patients were treated incorrectly (6 per cent were undertreated and 17 per cent were overtreated) with tetanus toxoid or human tetanus immunoglobulin. Undertreatment ranged(More)
As the number of older drivers increases, concern has been raised about the potential safety implications. Flexibility, coordination, and speed of movement have been associated with older drivers’ on road performance. To determine whether a multicomponent physical conditioning program targeted to axial and extremity flexibility, coordination, and speed of(More)