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2 results on '"Purnema Madahar"'

1. I-SPY COVID adaptive platform trial for COVID-19 acute respiratory failure: rationale, design and operations

Author

Carolyn S Calfee, Michael A Matthay, Paul Henderson, Martin Eklund, Laura J Esserman, Chirag Patel, Angela Haczku, Michelle Jung, Tony Oliver, Alessio Crippa, Andrea Discacciati, Kathleen D Liu, Ellen L Burnham, Nuala J Meyer, Fady A Youssef, Derek W Russell, Julie Lang, Kevin W Gibbs, Daniel C Files, Sheetal Gandotra, Purnema Madahar, Nathan K Cobb, Timothy E Albertson, Rajiv Sonti, John P Reilly, Alejandra Jauregui, Iván García, Luis E Huerta, Daniel Clark Files, Neil R Aggarwal, Adam L Asare, Jeremy R Beitler, Paul A Berger, George Cimino, Melissa H Coleman, Paul T Henderson, Caroline A G Ittner, Kashif T Khan, Jonathan L Koff, Mary LaRose, Joe Levitt, Ruixiao Lu, Jeffrey D McKeehan, Karl W Thomas, Aaron M Mittel, Albert F Yen, Alexis E Suarez, Alexis L Serra, Alpesh N Amin, Amanda Rosen, Amy L Dzierba, Anna D Barker, Ariel R Weisman, Brian M Daniel, Brian M Morrissey, Caroline AG Ittner, Chayse Jones, Christina Creel-Bulos, Christina M Angelucci, Diana Ng, Fredy Chaparro-Rojas, Gavin H Harris, Harsh V Barot, Heny Su, Jacqueline B Sutter, Jamal Dodin, Jerry S Lee, John Kazianis, Joshua F Detelich, Julie E Lang, Justin Muir, Katarzyna Gosek, Katherine L Nugent, Kimberly Yee, Laura G Rodrigues, Laura R Macias, Lindsey A Orr, Lindsie L Boerger, Lissette Rosario-Remigio, Lucia Kufa, Maged Tanios, Maria B Reyes, Max W Adelman, Maya M Juarez, Michelle Meyers, Mitchell P Sternlieb, Neil Aggarwal, Nilam S Mangalmurti, Patrice Jones, Paul L Saban, Peter S Marshall, Philiip A Robinson, Philip Yang, Rahul Nair, Richard Anthony Lee, Richard G Wunderink, Romina Wahab, Roxana A Lupu, Santhi I Kumar, Sara C Auld, Scott Fields, Se Fum Wong, Skyler J Pearson, Spencer Whealon, Timothy F Obermiller, Anita Darmanian, John Schicchi, Esmeralda Martinez, Farjad Sarafian, Julie Nguyen, Bethany Weiler-Lisowski, Jaime Wyatt, Daniel Blevins, Marylee Melendrez, Brenda Lopez, Hiwet Tzehaie, Omowunmi Amosu, Austin Simonson, Erin Hardy, Brett Lindgren, Gregory Peterfreund, Leigha Landreth, and Lisa Parks

Subjects
Medicine
Published
2022
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2. Clinical deterioration in older adults with delirium during early hospitalisation: a prospective cohort study

Author

S. Jean Hsieh, Jennifer Zapata, Purnema Madahar, Michelle N. Gong, and Aluko A. Hope

Subjects
Male, Patient Transfer, Pediatrics, medicine.medical_specialty, Critical Care, Geriatric Medicine, Population, INTERNAL MEDICINE, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Severity of illness, Prevalence, Humans, Medicine, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, education, Prospective cohort study, Aged, Aged, 80 and over, Geriatrics, education.field_of_study, business.industry, Incidence, Research, Incidence (epidemiology), Age Factors, Delirium, General Medicine, Emergency department, Prognosis, Intensive care unit, 3. Good health, Hospitalization, Logistic Models, Disease Progression, Female, New York City, medicine.symptom, Emergency Service, Hospital, business, 030217 neurology & neurosurgery
Abstract

Objectives To measure the prevalence and incidence of delirium in older adults as they transition from the emergency department (ED) to the inpatient ward, and to determine the association between delirium during early hospitalisation and subsequent clinical deterioration. Design Prospective cohort study. Setting Urban tertiary care hospital in Bronx, New York. Participants Adults aged 65 years or older admitted to the inpatient ward from the ED (n=260). Measurements Beginning in the ED, delirium was assessed daily for 3 days, using the Confusion Assessment Method for the Intensive Care Unit. Outcomes (1) Clinical deterioration, defined as unanticipated intensive care unit (ICU) admission or in-hospital death (primary outcome); (2) decline in discharge status, defined as discharge to higher level of care, hospice or in-hospital death. Results 38 of 260 participants (15%) were delirious at least once during the first 3 days of hospitalisation. Of the 29 (11%) patients with delirium in the ED (ie, hospital day 1), delirium persisted into hospital day 2 in 72% (n=21), and persisted for all 3 days in 52% (n=15). In multivariate analyses, as little as 1 episode of delirium during the first 3 days was associated with increased odds of unanticipated ICU admission or in-hospital death (adjusted OR 8.07 (95% CI 1.91 to 34.14); p=0.005). Delirium that persisted for all 3 days was associated with a decline in discharge status, even after adjusting for factors such as severity of illness and baseline cognitive impairment (adjusted OR 4.70 (95% CI 1.41 to 15.63); p=0.012). Conclusions Delirium during the first few days of hospitalisation was associated with poor outcomes in older adults admitted from the ED to the inpatient ward. These findings suggest the need for serial delirium monitoring that begins in the ED to identify a high-risk population that may benefit from closer follow-up and intervention.

Published
2015

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