Targeting cardiovascular events to improve patient outcomes after sepsis

针对心血管事件以改善脓毒症后患者的预后

• 批准号: 10219343
• 负责人: Allan J. Walkey
• 金额: $ 66.84万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219343
• 关键词: Address; Adrenergic beta-Antagonists; Affect; Aftercare; American; American Heart Association; Angiotensin-Converting Enzyme Inhibitors; Anticoagulants; Antiplatelet Drugs; Atrial Fibrillation; Benefits and Risks; Biological Markers; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Characteristics; Clinical; Clinical Trials; Collaborations; Data; Data Set; Diabetes Mellitus; Effectiveness; Electronic Health Record; Event; Future; Guidelines; Health; Heart Injuries; Heart failure; Hemorrhage; Hospitalization; Hospitals; Hyperlipidemia; Hypertension; Individual; Infection; Inflammation; Infrastructure; Injury to Kidney; Knowledge; Life; Methods; Modeling; Modification; Morbidity - disease rate; Myocardial Infarction; Outcome; Patient-Focused Outcomes; Patients; Pattern; Performance; Pharmaceutical Preparations; Physiological; Preventive; Preventive therapy; Recording of previous events; Risk; Risk Estimate; Risk Factors; Risk Reduction; Sepsis; Stroke; Structure; Survivors; Therapeutic; Thrombophilia; Time; Treatment Effectiveness; United States; Work; base; cardioprotection; cardiovascular risk factor; comorbidity; effectiveness evaluation; functional decline; high dimensionality; high risk; hospital readmission; improved; inhibitor/antagonist; innovation; insight; modifiable risk; mortality; novel; patient population; personalized approach; randomized trial; response; risk prediction model

ABSTRACT / PROJECT SUMMARY We propose the “Targeting cardiovascular events to improve patient outcomes after sepsis” study to identify opportunities to improve long-term patient outcomes after sepsis through the discovery of novel, potentially modifiable, risk factors for post-sepsis cardiovascular events. Sepsis is a life-threatening, dysregulated response to infection and the most common illness leading to hospitalization in the United States, affecting ~1 million Americans yearly. Cardiovascular complications are among the most common reasons for morbidity, re- hospitalization and death after sepsis. Approximately 1 in 3 sepsis survivors are hospitalized for cardiovascular events in the year following sepsis. Cardiovascular complications after sepsis are common, but the risk factors are undefined and likely differ from traditional cardiac risk factors. In addition, prescribing patterns of potentially cardio-protective medications are unclear and effectiveness of traditional cardiovascular risk-modifying treatments after sepsis are uncertain. We propose to use longitudinal, granular, electronic health record data across multiple centers to address knowledge gaps involving predictors of cardiovascular complications, practice patterns of cardiovascular risk modification, and effectiveness of therapies prescribed to reduce cardiovascular risk in the especially vulnerable period after sepsis. We have assembled a team with expertise in using longitudinal electronic health record data to study novel cardiovascular risk factors and sepsis with state-of-the-art methods. Results from our study will provide new insights into the common intersection of sepsis with cardiovascular events and will inform current therapeutic strategies, as well as the conduct of future randomized trials investigating novel methods to reduce cardiovascular complications and improve patient outcome after sepsis.

摘要 /项目摘要 我们提出“针对心血管事件，以改善败血症后的患者结局”，以识别 通过发现新颖的机会，有机会改善败血症后的长期患者结局 可修改的，七个后心血管事件的危险因素。败血症是一种威胁生命的，失调的 对感染的反应和导致美国住院治疗的最常见疾病，影响约1 每年百万美国人。心血管并发症是发病率的最常见原因之一 败血症后的住院和死亡。大约3个败血症存活中的1分之一的心血管住院 败血症后一年的活动。败血症后的心血管并发症很常见，但风险因素 是未定义的，可能与传统的心脏危险因素不同。另外，开处方的模式 有心脏保护药物不清楚，传统心血管风险改造的有效性 败血症后的治疗尚不确定。我们建议使用纵向，颗粒状，电子健康记录数据 在多个中心，以解决涉及心血管并发症预测指标的知识差距， 练习心血管风险改变的模式以及规定减少的疗法的有效性 败血症后特别脆弱时期的心血管风险。我们已经组建了一个具有专业知识的团队 使用纵向电子健康记录数据来研究新颖的心血管危险因素和败血症 最先进的方法。我们研究的结果将提供有关共同交集的新见解 带有心血管事件的败血症，将为当前的理论策略以及未来的行为提供信息 随机试验调查了减少心血管并发症并改善患者的新方法 败血症后的结果。

项目成果

Variation in Use of Repurposed Medications Among Patients With Coronavirus Disease 2019. From The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 Registry Investigator Group.

• DOI: 10.1097/cce.0000000000000566
• 发表时间: 2021-11
• 期刊: Critical care explorations
• 作者: Garcia MA;Johnson SW;Bosch NA;Sisson EK;Sheldrick CR;Kumar VK;Boman K;Bolesta S;Bansal V;Deo N;Domecq JP;Lal A;Christie AB;Banner-Goodspeed VM;Sanghavi D;Vadgaonkar G;Gajic O;Kashyap R;Walkey AJ
• 通讯作者: Walkey AJ

SARS-CoV-2 With Concurrent Respiratory Viral Infection as a Risk Factor for a Higher Level of Care in Hospitalized Pediatric Patients.

SARS-CoV-2 并发呼吸道病毒感染是住院儿科患者接受更高水平护理的危险因素。

• DOI: 10.1097/pec.0000000000002814
• 发表时间: 2022
• 期刊: Pediatric emergency care
• 影响因子: 1.4
• 作者: Dikranian,Lea;Barry,Suzanne;Ata,Ashar;Chiotos,Katie;Gist,Katja;Bhalala,Utpal;Danesh,Valerie;Heavner,Smitty;Gharpure,Varsha;Bjornstad,EricaC;Irby,Olivia;Heneghan,JuliaA;Montgomery,Vicki;Gupta,Neha;Miller,Aaron;Walkey,Allan

"Microclimates" of Care for Hospitalized Patients with Pulmonary Disease: An Idea That Will Bear Fruit?

肺部疾病住院患者护理的“小气候”：一个会开花结果的想法吗？

• DOI: 10.1513/annalsats.201910-809ed
• 发表时间: 2020
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3
• 作者: Lyons,PatrickG;Walkey,AllanJ
• 通讯作者: Walkey,AllanJ

Exploring the Pathways Revealed by International Sepsis Benchmarking.

探索国际脓毒症基准测试揭示的途径。

• DOI: 10.1097/ccm.0000000000003485
• 发表时间: 2019
• 期刊: Critical care medicine
• 影响因子: 8.8
• 作者: Walkey,AllanJ

Should We Agree to Disagree on Who May Benefit From ICU Admission?

关于谁可以从 ICU 入院中受益，我们应该同意还是不同意？

• DOI: 10.1097/ccm.0000000000003495
• 发表时间: 2019
• 期刊: Critical care medicine
• 影响因子: 8.8
• 作者: Law,AnicaC;Walkey,AllanJ
• 通讯作者: Walkey,AllanJ