Clinical risk factors and biological predictors of sepsis-related acute lung...

脓毒症相关急性肺的临床危险因素和生物学预测因子

• 批准号: 7662038
• 负责人: CHIRAG Vijay SHAH
• 金额: $ 6.01万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2009-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7662038
• 关键词: Accident and Emergency department; Accounting; Acute; Acute Lung Injury; Acute respiratory failure; Alcohol consumption; Alveolar; Animal Model; Antithrombin III; Area; Bilateral; Biological; Biological Factors; Biological Markers; Biometry; Blood Coagulation Disorders; Cardiac; Cause of Death; Cessation of life; Chronic; Clinical; Coagulation Process; Cohort Studies; Comorbidity; Critical Care; Demographic Aging; Deposition; Development; Diabetes Mellitus; Disease; Doctor of Medicine; Early treatment; Educational workshop; Enrollment; Environmental air flow; Epidemiologic Studies; Epidemiologist; Epidemiology; Event; Faculty; Fibrin; Fibrinolysis; Foundations; Frequencies; Future; Gender; HIV; Health Care Costs; Heart Atrium; Hospitals; Hypersensitivity; Hypertension; Hypoxemia; Immunocompromised Host; Incidence; Individual; Infection; Inflammation; Instruction; Intensive Care Units; Intervention Trial; Left; Leukocytes; Light; Literature; Liver diseases; Lung; Measures; Medicine; Methods; Modality; Modeling; National Heart, Lung, and Blood Institute; Nature; Organism; Outcome; Pathogenesis; Pathway interactions; Patients; Pennsylvania; Phase; Phenotype; Physicians; Plasma; Preceptorship; Predictive Value; Preventive; Protein C; Pulmonary Edema; Race; Refractory; Reporting; Research; Research Personnel; Research Proposals; Resistance; Resources; Risk; Risk Factors; Role; Sampling; Sensitivity and Specificity; Sepsis; Source; Subgroup; TNFR-Fc fusion protein; Target Populations; Techniques; Testing; Thromboplastin; Tobacco use; Training; Training Programs; Translational Research; Triage; United States; University Hospitals; Urokinase; Vascular Permeabilities; abstracting; aging population; attributable mortality; base; career development; clinical epidemiology; cohort; high risk; improved; indexing; inhibitor/antagonist; injured; instructor; malignant breast neoplasm; mortality; novel; predictive modeling; prevent; programs; prospective; treatment strategy; Accident and Emergency department; Accounting; Acute; Acute Lung Injury; Acute respiratory failure; Alcohol consumption; Alveolar; Animal Model; Antithrombin III; Area; Bilateral; Biological; Biological Factors; Biological Markers; Biometry; Blood Coagulation Disorders; Cardiac; Cause of Death; Cessation of life; Chronic; Clinical; Coagulation Process; Cohort Studies; Comorbidity; Critical Care; Demographic Aging; Deposition; Development; Diabetes Mellitus; Disease; Doctor of Medicine; Early treatment; Educational workshop; Enrollment; Environmental air flow; Epidemiologic Studies; Epidemiologist; Epidemiology; Event; Faculty; Fibrin; Fibrinolysis; Foundations; Frequencies; Future; Gender; HIV; Health Care Costs; Heart Atrium; Hospitals; Hypersensitivity; Hypertension; Hypoxemia; Immunocompromised Host; Incidence; Individual; Infection; Inflammation; Instruction; Intensive Care Units; Intervention Trial; Left; Leukocytes; Light; Literature; Liver diseases; Lung; Measures; Medicine; Methods; Modality; Modeling; National Heart, Lung, and Blood Institute; Nature; Organism; Outcome; Pathogenesis; Pathway interactions; Patients; Pennsylvania; Phase; Phenotype; Physicians; Plasma; Preceptorship; Predictive Value; Preventive; Protein C; Pulmonary Edema; Race; Refractory; Reporting; Research; Research Personnel; Research Proposals; Resistance; Resources; Risk; Risk Factors; Role; Sampling; Sensitivity and Specificity; Sepsis; Source; Subgroup; TNFR-Fc fusion protein; Target Populations; Techniques; Testing; Thromboplastin; Tobacco use; Training; Training Programs; Translational Research; Triage; United States; University Hospitals; Urokinase; Vascular Permeabilities; abstracting; aging population; attributable mortality; base; career development; clinical epidemiology; cohort; high risk; improved; indexing; inhibitor/antagonist; injured; instructor; malignant breast neoplasm; mortality; novel; predictive modeling; prevent; programs; prospective; treatment strategy

DESCRIPTION (provided by applicant): Chirag Shah, M.D., M.S.C.E., is an Instructor of Medicine in the Pulmonary, Allergy & Critical Care Division at the Hospital of the University of Pennsylvania and a Faculty-Fellow at Penn's Center for Clinical Epidemiology and Biostatistics (CCEB). The career development component of the 5-year training program proposed herein includes a preceptorship with Drs. Stephen Kimmel and Steven Albelda and formal coursework in epidemiology, biostatistics, and translational research. This program of didactic and applied instruction will extend Dr. Shah's prior training, will be directly applicable to the timely completion of his research proposal, and will provide him with the necessary foundation to become an independent translational epidemiologist in the field of sepsis. Despite advances in critical care, both sepsis and acute lung injury (All) continue to have high mortality rates and tremendous acute and long term health care costs. Development of ALI after sepsis worsens clinical outcomes and despite its importance, it is not clearly understood why certain individuals with sepsis develop ALI. The primary hypotheses underlying Dr. Shah's project are that baseline clinical variables related to the patient and the infectious insult are associated with an increased risk for development of ALI after sepsis and that baseline clinical variables and plasma biomarkers of coagulation and inflammation have predictive value for sepsis-relalated ALI. The proposed project, a large-scale prospective cohort study of severe sepsis patients, aims to examine the independent association between clinical variables and the risk of sepsis-related ALI and to develop and validate a model to predict ALI after sepsis using both clinical variables and biomarkers measured in the emergency room. Key interactions between clinical and biological factors in the development of ALI in sepsis patients will also be evaluated. RELEVANCE (See instructions): Greater understanding of the clinical risk factors for ALI after sepsis may inform researchers of the potential mechanisms of these associations. A better ability to predict which sepsis patients will develop ALI will aid physicians in implementing potential therapies earlier, triaging patients more efficiently, allocating ICU resources more appropriately, and risk-stratifying patients for enrollment into clinical intervention trials. (End of Abstract)

描述（由申请人提供）：M.D.，M.S.C.E. M.D. Chirag Shah是宾夕法尼亚大学医院肺，过敏和重症监护室的医学讲师，也是宾夕法尼亚大学临床流行病学和生物统计学临床中心的教师中心（CCEB）。本文提出的为期5年培训计划的职业发展组成部分包括与DRS的主持。 Stephen Kimmel和Steven Albelda以及流行病学，生物统计学和转化研究的正式课程。该教学和应用指导的计划将扩大Shah博士的先前培训，直接适用于及时完成其研究建议，并将为他提供必要的基础，以成为败血症领域的独立翻译流行病学家。尽管重症监护的进展，败血症和急性肺损伤（全部）仍具有高死亡率，急性和长期医疗保健费用。败血症后ALI的发展恶化了临床结局，尽管其重要性，但尚不清楚某些败血症患者会发展ALI的原因尚不清楚。 Shah博士项目的主要假设是，与患者有关的基线临床变量和传染性损伤与败血症后ALI的发展风险增加有关，而基线临床变量和凝血和炎症的等离子生物标志物具有预测的败血症染色ALI的预测价值。拟议的项目是对严重败血症患者的大规模前瞻性队列研究，旨在检查临床变量与脓毒症相关ALI的风险之间的独立关联，并开发和验证模型，并验证使用在急诊室中测量的临床变量和生物标志物在脓毒症后预测ALI的模型。还将评估败血症患者ALI发展中临床和生物学因素之间的主要相互作用。相关性（请参阅说明）：对败血症后ALI的临床风险因素的更多了解可能会告知研究人员这些关联的潜在机制。更好地预测哪些败血症患者将开发ALI的能力更好，可以帮助医生较早地实施潜在的疗法，更有效地对患者进行分类，更适当地分配ICU资源，并使风险分层的患者参加临床干预试验。 （抽象的结尾）