Leaders in Research

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Edward R. Marcantonio, MD, SM Director of Research and Associate Professor of Medicine Division of General Medicine and Primary Care Harvard Medical School Edward R. Marcantonio, M.D., S.M. Dr. Marcantonio is an Assistant Professor of Medicine at Harvard Medical School and the Director of Quality Assurance and Outcomes Research at the Hebrew Rehabilitation Center for Aged. His general academic interest is to improve the quality of clinical care for vulnerable elderly patients using the techniques of clinical epidemiology and health services research. During his first exposure to clinical medicine at Harvard Medical School, he was impressed that knowledge of basic biology had far outstripped knowledge of how to best deliver clinical care. Because this statement is even more true for vulnerable aged persons from whom the traditional medical paradigms often fail, he became committed to clinical research in geriatric medicine. After pursuing methodological and clinical training through a combined fellowship in general medicine and gerontology at HMS, as well as preparation for a Masters in Epidemiology from the Harvard School of Public Health, he has applied these methods to the study of hospitalized elderly, focusing on acute confusion, or delirium. Delirium, a transient dysfunction of the mind, is both an interesting clinical phenomenon in its own right, but more importantly, as an indicator of how well we are managing frail elderly at vulnerable periods in their lives. Dr. Marcantonioƒ­s studies have heretofore focused on delirium in hospitalized patients undergoing elective non-cardiac surgery and emergency hip fracture repair. He has performed both natural history studies examining risk factors and outcomes of delirium, as well as a randomized trial to determine if proactive geriatrics consultation can reduce the incidence of delirium after hip fracture repair. While carrying out these studies, which have also demonstrated the persistence of delirium beyond the hospital and its negative impact on outcome, it has become clear that future studies must focus on the resolution of this problem in post-acute care. During the years of his Beeson Scholarship, Dr. Marcantonio is performing an interventional trial to determine whether post-acute care can be modified to shorten the persistence of delirium, as well as lessen its negative impact on functional recovery.

Primary Research (for Beeson Program): The Prevalence Of Delirium And Subsyndromal Delirium Among Admissions To Post-Acute Skilled Nursing Facilities.