The PREDICT Study (PRE-ICU Determinants of Post-ICU FunCTional Outcomes among Older Adults)

PREDICT 研究（ICU 前老年人 ICU 后功能结果的决定因素）

• 批准号: 10205952
• 负责人: Lauren Ferrante
• 金额: $ 21.74万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10205952
• 关键词: Address; Admission activity; Adult; Age; Aging; American; Award; Calibration; Capsicum; Career Choice; Caring; Cessation of life; Chest; Clinical; Clinical Trials; Clinical assessments; Cognitive; Country; Critical Care; Critical Illness; Data; Data Analyses; Data Collection; Dependence; Development Plans; Discrimination; Elderly; Elements; Emotional; Environment; Epidemiology; Event; Evidence based intervention; Geriatrics; Gills; Goals; Grant; Health; Home; Hospitals; Impaired cognition; Independent Living; Individual; Institutionalization; Intensive Care Units; Intervention; Knowledge; Longitudinal Studies; Lung; Mechanical ventilation; Medical; Medical Societies; Medical center; Medicine; Mentors; Mentorship; Morbidity - disease rate; Outcome; Outcomes Research; Patients; Physicians; Population; Prevention; Probability; Prospective cohort study; Provider; Public Health; Public Health Schools; Publications; Recovery; Reporting; Research; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Risk Assessment; Risk Factors; Scientist; Services; Shock; Sleep; Societies; Survivors; Testing; Training; Translating; United States; Validation; Work; acceptability and feasibility; adverse outcome; career; career development; clinical epidemiology; cohort; design; disability; experience; functional outcomes; hearing impairment; high risk; improved; improved outcome; innovation; longitudinal dataset; medical schools; medical specialties; mortality; patient oriented; predictive tools; programs; research and development; risk prediction; skills; success; survivorship; tertiary care; tool; trend; working group

PROJECT SUMMARY/ABSTRACT Candidate: My career goal is to become an independent physician-scientist and national leader in geriatric critical care outcomes research whose body of work improves the long-term functional outcomes of critically ill older adults. My clinical training as a Pulmonary & Critical Care Medicine (PCCM) physician and research training in Geriatric Clinical Epidemiology have prepared me to pursue this career path. My track record of early success is evidenced by the publication of high-impact original reports and the receipt of 3 grants, including a GEMSSTAR award. I have already distinguished myself as a national leader in my specialty as well as in geriatrics: I founded and am co-chair of the American Thoracic Society Critical Care Assembly's Aging and Geriatrics Working Group, and was recently selected as an incoming co-chair of the American Geriatrics Society (AGS) Medical Subspecialties Section. My research efforts have been recognized nationally, with the AGS New Investigator Award, and at Yale, with the prestigious Iva Dostanic Physician-Scientist Award. Mentors and Environment: I have an exceptional team of mentors and advisors, including my primary mentor Dr. Thomas Gill (Geriatrics), a leading expert on the epidemiology and prevention of disability, co-mentor Dr. Margaret Pisani (PCCM), an expert in critical care outcomes research, and advisor Dr. Terrence Murphy, a biostatistician with expertise in longitudinal studies of aging and critical care outcomes research. My research and career development plans draw on the wealth of resources available at Yale, including the Yale Program on Aging/Claude D. Pepper Older Americans Independence Center, the Yale School of Public Health, and one of the largest intensive care units (ICUs) in the country at Yale-New Haven Hospital. These resources, and the support provided by the Section of Pulmonary, Critical Care, and Sleep Medicine at the Yale School of Medicine, provide an ideal environment for my career development and execution of the proposed research. Mentored Research Project: Nearly 1.4 million older adults survive an ICU stay each year, and many of these will suffer from increased disability. Our prior work has demonstrated that premorbid factors are strongly associated with the course of disability after a critical illness – yet no mechanism exists to identify which older ICU patients are at risk of increased disability. To address this knowledge gap, I have proposed an innovative research project that leverages the wealth of resources available at Yale in addition to two high-quality longitudinal datasets: the National Health and Aging Trends Study (NHATS) and Precipitating Events Project (PEP). The overall objective is to develop, externally validate, and pilot test a predictive tool (that incorporates premorbid risk factors) to identify older ICU patients at risk of worsening post-ICU disability and provide a personal estimate of the increase in disability. The results will inform the design and conduct of a larger prospective cohort study to test the accuracy of the tool in predicting post-ICU disability as well as a subsequent clinical trial testing interventions to improve post-ICU functional outcomes among older adults.

项目摘要/摘要 候选人：我的职业目标是成为老年医学的独立身体科学家和国家领导者 重症监护结果研究，其工作体系改善了重病的长期功能结果 老年人。我作为肺和重症监护医学（PCCM）的临床培训 老年临床流行病学的培训使我为追求这一职业道路做好了准备。我的记录 发表高影响力原始报告和3赠金的出版证明了早期的成功， 包括Gemsstar奖。我也已经在自己的专业中成为国家领导者 如老年医学：我建立并是美国胸部社会重大护理大会老龄化的联合主席 和老年医学工作组，最近被选为美国老年医学家的传入联合主席 社会（AGS）医学亚专有部分。我的研究工作在全国范围内得到了认可， AGS新调查员奖，并在耶鲁大学获得了著名的IVA Dostanic医师 - 科学家奖。 导师和环境：我有一个杰出的导师和顾问团队，包括我的主要导师 托马斯·吉尔（Thomas Gill）博士（老年医学）是流行病学和预防残疾的领先专家，同事博士 重症监护结果研究专家玛格丽特·皮萨尼（PCCM）和顾问特伦斯·墨菲（Terrence Murphy）博士 生物统计学家在衰老和重症监护结果研究的纵向研究中具有专业知识。我的研究 和职业发展计划借鉴了耶鲁大学可用的大量资源，包括耶鲁大学计划 关于老化/克劳德·D·胡椒老年人独立中心，耶鲁公共卫生学院，一个 该国在耶鲁 - 新避风港医院的最大重症监护病房（ICU）中。这些资源，以及 耶鲁学校的肺部，重症监护和睡眠医学部分提供的支持 医学为我的职业发展和拟议研究的执行提供了理想的环境。 指导的研究项目：每年有近140万老年人在ICU住宿中幸存下来，其中许多 残疾人会遭受增加的困扰。我们先前的工作表明，病前因素是强烈的 与危重疾病后的残疾进程相关 - 但没有任何机制来确定哪个年龄较大 ICU患者有残疾增加的风险。为了解决这个知识差距，我提出了创新的 除两种高质量的研究项目外，还利用耶鲁大学可用的大量资源 纵向数据集：国家健康和衰老趋势研究（NHATS）和促进事件项目 （PEP）。总体目标是开发，外部验证和试点测试一种预测工具（该工具 病前风险因素），以确定有担心ICU残疾的风险的老年ICU患者，并提供 个人估计残疾的增加。结果将为较大的设计和行为提供信息 前瞻性队列研究以测试该工具在预测ICU后残疾和 随后的临床试验测试干预措施，以改善老年人的ICU后功能结果。