Understanding the Global Burden of Disease of Skeletal Fractures: the International Orthopaedic Multi-Center Study (INORMUS)

了解骨骼骨折的全球疾病负担：国际骨科多中心研究 (INORMUS)

• 批准号: 10267668
• 负责人: Mohit Bhandari
• 金额: $ 27.45万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-21 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10267668
• 关键词: 18 year old; Address; Adult; Africa; Asia; Atherosclerosis; Australia; Caring; Cause of Death; Cessation of life; Characteristics; Clinical Trials; Collaborations; Country; Data; Developing Countries; Development; Disabled Persons; Early treatment; Enrollment; Ensure; Fatality rate; Fracture; Frequencies; Funding; Funding Agency; Future; Geographic Locations; Goals; Gross National Product; Health; Hospitalization; Hospitals; Human; Human Resources; Incidence; Income; India; Individual; Infection; Informed Consent; Injury; Institutes; International; Intervention; Knowledge; Latin America; Latin American; Left; Life; Limb structure; Low income; Malignant Neoplasms; Medical Research; Morbidity - disease rate; Multicenter Studies; Orthopedics; Outcome; Outcome Study; Participant; Patient Care; Patient-Focused Outcomes; Patients; Pattern; Persons; Physicians; Population; Prevention strategy; Primary Prevention; Progress Reports; Prospective Studies; Prospective cohort study; Reporting; Request for Proposals; Research; Resource Allocation; Resources; Risk; Safety; Sample Size; Savings; Secondary Prevention; Strategic Planning; Sustainable Development; System; Testing; Time; Traffic accidents; Trauma; Treatment Factor; United Nations; United States National Institutes of Health; Variant; Vehicle crash; Violent injury; Woman; World Bank; World Health Organization; age group; attributable mortality; burden of illness; clinical development; clinical research site; cohort; cost; improved; improved outcome; injured; injury burden; injury prevention; low and middle-income countries; men; mortality; musculoskeletal injury; operation; prevent; recruit; response; skeletal disorder; societal costs; statistics; treatment site

PROJECT SUMMARY Trauma is the leading cause of death in the first 4 decades of life and, for every person killed as a result of an injury, multiple individuals are left permanently disabled. Musculoskeletal (MSK) injuries are highly common manifestations of trauma, occurring in over 60% of victims. Given the degree of human suffering and societal costs associated with these injuries, there is a need to identify key targets for improving patient outcomes following musculoskeletal trauma. The World Health Organization's Global Road Traffic Safety Report (2013), in response to the ongoing Decade of Road Traffic Safety, recommended a focus on research and interventions in low-middle income countries (LMICs) with the goal of using evidence-driven solutions to prevent complications following injuries. We are conducting a large, global prospective cohort study (INORMUS) in patients with musculoskeletal trauma. We have funding to enroll 35,000 patients across Africa and Asia. The current proposal requests additional critical funds to enroll 5,000 patients from Latin America to achieve our global target sample size of 40,000 patients. INORMUS aims to determine, among adult individuals who present to hospital with musculoskeletal trauma, the following: 1) mechanisms of injury and details of early treatment and transport to hospital; 2) the incidence of major complications (mortality, re-operation and infection) within 30 days post-hospital admission; and 3) modifiable and non-modifiable patient, system, and treatment factors associated with these major complications. All patients 18 years of age or older who present to a recruiting clinical site for treatment of an orthopaedic injury that occurred within 3 months are eligible for participation. After obtaining informed consent, study personnel obtain information on mechanism of injury, early treatment and transport, and patient characteristics that are potential predictors of major complications. We follow study participants for 30 days post-hospital admission and assess each patient for the study outcomes. The INORMUS study will provide critically important estimates of musculoskeletal trauma burden and mechanism of injury to address ongoing knowledge gaps worldwide, thus enabling organizations such as the WHO to prioritize the most imperative action items of the road traffic injury prevention initiative. Identification of patient and system level factors associated with major complications will allow physicians to better identify and care for at-risk patients and enable knowledge leaders to lobby for strategic allocation of resources to improve outcomes for musculoskeletal injury patients. Further, given the consistencies in trauma patterns and outcomes across populations, these results will provide critical information, not only in LMICs, but also in well-resourced countries. The INORMUS study aligns with the strategic plan of the NIH to support studies that will inform the development of future clinical trials to evaluate life and limb saving interventions.

项目摘要 创伤是生命的头四十年中死亡的主要原因，因为 受伤，多个人被永久残疾。肌肉骨骼（MSK）受伤非常普遍 创伤的表现，发生在60％以上的受害者中。鉴于人类苦难和社会的程度 与这些伤害相关的成本，有必要确定改善患者预后的关键目标 跟随肌肉骨骼创伤。世界卫生组织的全球道路交通安全报告（2013年）， 为了响应正在进行的道路交通安全的十年，建议将重点放在研究和干预措施上 在低中型收入国家（LMIC）中，目的是使用证据驱动的解决方案来防止 受伤后的并发症。我们正在进行一项大型全球前瞻性队列研究（inormus） 肌肉骨骼创伤的患者。我们有资金用于在非洲和亚洲招募35,000名患者。这 当前的提案要求额外的重要资金，以招募来自拉丁美洲的5,000名患者，以实现我们的 40,000名患者的全球目标样本量。在出席的成年人中，求婚旨在确定 患有肌肉骨骼创伤的医院，以下：1）损伤机制和早期治疗的细节 并运送到医院； 2）在 院后入院30天； 3）可修改和不可修改的患者，系统和治疗因素 与这些主要并发症有关。所有18岁以上的患者出现在招聘临床上 3个月内发生的骨科损伤的治疗部位有资格参加。获得后 知情同意书，学习人员获得有关伤害机制，早期治疗和运输机制的信息，以及 患者特征是主要并发症的潜在预测指标。我们跟随研究参与者30 院后入院并评估每个患者的研究结果。艾莫斯研究将提供 肌肉骨骼创伤负担和伤害机制的至关重要的估计值 知识差距在全球范围 道路交通伤害预防计划。识别患者和系统级别因素 由于重大并发症将使医生能够更好地识别和照顾高危患者，并启用 知识领袖游说战略分配资源以改善肌肉骨骼损伤的结果 患者。此外，鉴于跨种群的创伤模式和结果的一致性，这些结果将 不仅在LMIC中，而且在资源丰富的国家中提供关键信息。肌肉研究对齐 通过NIH的战略计划来支持研究，这些研究将为未来的临床试验发展开发 评估生命和肢体挽救干预措施。

项目成果

International Orthopaedic Multicenter Study in Fracture Care: Coordinating a Large-Scale Multicenter Global Prospective Cohort Study.

国际骨科骨折护理多中心研究：协调大规模多中心全球前瞻性队列研究。

• DOI: 10.1097/bot.0000000000001287
• 发表时间: 2018
• 期刊: Journal of orthopaedic trauma
• 影响因子: 2.3
• 作者: Sprague,Sheila;McKay,Paula;Li,ChuanSilvia;Ivers,Rebecca;Moroz,PaulJ;Jagnoor,Jagnoor;Bhandari,Mohit;Miclau,Theodore;INORMUSInvestigators
• 通讯作者: INORMUSInvestigators