Dr. Sieber’s research focuses on problems specific to geriatric surgical patients and on optimization of their surgical outcomes. Through multidisciplinary clinical research, he studies elderly surgical patients, especially those undergoing orthopedic procedures.
At Johns Hopkins Bayview Medical Center, a multidisciplinary Hip Fracture Service has been ongoing since the late 1990s. The service includes Anesthesiology (Dr. Sieber and Mary-Rita Blute, RN, MS), Orthopaedics (Drs. Simon Mears and Tariq Nayfeh), Geriatrics (Dr. Jeremy Walston), and Neuropsychiatry (Drs. Constantine Lyketsos, Benjamin Lee, and Paul Rosenberg). Several members of the Hip Fracture Service have funded clinical research projects. Dr. Mears, for example, has a grant from the Orthopaedic Trauma Association to study inflammatory markers of delirium in elderly surgical patients who have had a repair of a traumatic hip fracture or who have had an elective hip replacement. Dr. Mears and the Anesthesiology team collect perioperative cerebrospinal fluid and blood samples from these patients to measure inflammatory and dementia markers and their possible relationships to postoperative delirium.
Second, an NIH-funded multi-center trial is investigating whether the sedative dexmedetomidine attenuates postoperative delirium and cognitive dysfunction in elderly surgical patients. Dr. Sieber is Johns Hopkins’ principal investigator for this trial.
Third, in another NIH-funded clinical trial, Dr. Sieber and his team are researching the effects of depth of sedation (as measured by the BIS monitor and the OAA/S score) during regional anesthesia with propofol on the incidence of postoperative delirium, cognitive dysfunction and mortality in elderly hip fracture patients.
- Sieber FE, Gottschalk A, Zakriya KJ, Mears SC, Lee H. Reply to letter to the editor concerning manuscript “General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia”. J Clin Anesth 23:80-81, 2011.
- Thakkar SC, Sieber FE, Zakriya KJ, Mears SC. “Eight-year follow-up on the effect of a hip fracture service on patient care and outcome.” J Surg Orthop Adv. 19:223-8, 2010.
- Sieber FE, Gottschalk A, Zakriya KJ, Mears SC, Lee H. “General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia.” J Clin Anesth 22:179-83, 2010.
- Sieber FE. “Decreasing postoperative delirium in the elderly: the role of sedation depth.” Editorial. Aging Health 6(3):267-8, 2010.
- Sieber FE, Zakriya KJ, Gottschalk A, Blute MR, Lee HB, Rosenberg PB, Mears SC. “Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair.” Mayo Clin Proc 85(1):18-26, 2010. Paper has accompanying editorial.
- Sieber FE. “Postoperative delirium in the elderly surgical patient.” Anesthesiol Clin 27(3):451-64, 2009.
- Pauldine R, Sieber FE. “Considerations for intensive care of the geriatric patient.” Contemp Crit Care 6(8):1-12, 2009.
- Lee HB, DeLoatch CJ, Cho S, Rosenberg P, Mears SC, Sieber FE. “Detection and management of pre-existing cognitive impairment and associated behavioral symptoms in the critical care unit.” Crit Care Clin 24(4):723-36, 2008.
- Sharma PT, Sieber FE, Zakriya KJ, Pauldine RW, Gerold KB, Hang J, Smith TH. “Recovery room delirium predicts postoperative delirium after hip fracture repair.” Anesth Analg 101:1215-20, 2005
- Viscusi ER, Martin G, Hartrick CT, Singla N, Manvelian G, the EREM Study Group. “Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation.” Anesthesiology 102:1014-22, 2005.
- John AD, Sieber FE. “Age-associated issues: geriatrics.” Anesthesiol Clin North America 22:45-58, 2004.
- Zakriya K, Sieber FE, Christmas C, Wenz JF Sr., Franckowiak S. “Brief postoperative delirium in hip fracture patients affects functional outcome at three months.” Anesth Analg 98:1798-802, 2004.
- Zakriya KJ, Christmas C, Wenz JF Sr, Franckowiak S, Andersen RA, Sieber FE. “Preoperative factors associated with postoperative change in confusion assessment method score in hip fracture patients.” Anesth Analg 94:1628-32, 2002.
- De Jonge KE, Christmas C, Andersen R, Franckowiak SC, Mears SC, Levy P, Wenz JF, Sieber F. “Hip Fracture Service: an interdisciplinary model of care.” J Am Geriatr Soc 49(12):1737-8, 2001.
STRIDE- Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients (trial registered at ClinicalTrials.gov under registration number: NCT00590707)