Margaret A Pisani

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OBJECTIVE There is a high prevalence of delirium in older medical intensive care unit (ICU) patients and delirium is associated with adverse outcomes. We need to identify modifiable risk factors for delirium, such as medication use, in the ICU. The objective of this study was to examine the impact of benzodiazepine or opioid use on the duration of ICU(More)
OBJECTIVES To describe the occurrence of delirium in a cohort of older medical intensive care unit (ICU) patients and its short-term duration in the hospital and to determine the association between preexisting dementia and the occurrence of delirium. DESIGN Prospective cohort study. SETTING Fourteen-bed medical ICU of an 800-bed university teaching(More)
RATIONALE Delirium is a frequent occurrence in older intensive care unit (ICU) patients, but the importance of the duration of delirium in contributing to adverse long-term outcomes is unclear. OBJECTIVES To examine the association of the number of days of ICU delirium with mortality in an older patient population. METHODS We performed a prospective(More)
OBJECTIVES To determine the prevalence of preexisting cognitive impairment (CI) in patients admitted to the medical intensive care unit (ICU) and compare two different proxy measures of preexisting CI in ICU patients. DESIGN Cross-sectional comparative study. SETTING Urban university teaching hospital. PARTICIPANTS One hundred thirty patients aged 65(More)
IMPORTANCE Little is known about functional trajectories of older persons in the year before and after admission to the intensive care unit (ICU) or how pre-ICU functional trajectories affect post-ICU functional trajectories and death. OBJECTIVES To characterize functional trajectories in the year before and after ICU admission and to evaluate the(More)
People over age 65 are the fastest growing segment of the population and account for 42% to 52% of the intensive care unit admissions in the United States. There are many physiologic changes that occur with aging which can impact on both the presentation and management of older patients with critical illness. Older patients have an increased risk for the(More)
With the introduction of highly active antiretroviral therapy (HAART), HIV has become a chronic disease. As HIV-infected patients are aging, they are at increased risk for comorbid diseases. These non-AIDS related diseases account for a growing proportion of intensive care unit (ICU) admissions in HIV-infected patients in recent studies. HIV-infected(More)
INTRODUCTION Delirium is a serious and prevalent problem in intensive care units (ICU). The purpose of this study was to develop a research algorithm to enhance detection of delirium in critically ill ICU patients using chart review to complement a validated clinical delirium instrument. METHODS Prospective cohort study of 178 patients 60 years and older(More)
OBJECTIVES To compare the Confusion Assessment Method (CAM) and CAM for the Intensive Care Unit (CAM-ICU) methods for detecting delirium in alert, nonintubated older ICU patients. DESIGN Comparison study. SETTING Fourteen-bed medical ICU of an 800-bed university teaching hospital. PARTICIPANTS Twenty-two patients aged 65 and older admitted to the ICU.(More)
INTRODUCTION We assessed smoking data from the Veterans Health Administration (VHA) electronic medical record (EMR) Health Factors dataset. METHODS To assess the validity of the EMR Health Factors smoking data, we first created an algorithm to convert text entries into a 3-category smoking variable (never, former, and current). We compared this EMR(More)