Risk Factors for Sepsis in the Community

社区败血症的危险因素

• 批准号: 8192635
• 负责人: Henry E. Wang
• 金额: $ 56.13万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8192635
• 关键词: Acute myocardial infarction; Adult; Alcohol consumption; Ancillary Study; Antibiotic Resistance; Breast; Cardiovascular Diseases; Caring; Case Fatality Rates; Cellulitis; Cessation of life; Characteristics; Cohort Studies; Communities; Community Healthcare; Comorbidity; Diabetes Mellitus; Elements; Event; Family; Family Characteristics; Funding; Health; Health Professional; Healthcare; Healthcare Systems; Hospitalization; Hospitals; Individual; Infection; Inflammation; Influenza; Kidney Failure; Life; Malignant neoplasm of lung; Mediating; Medical; Medically Underserved Area; Medicare; Meningitis; National Institute of Neurological Disorders and Stroke; Obesity; Organ; Performance; Pneumonia; Predisposition; Prevention; Process; Public Health; Quality Indicator; Quality of Care; Reasons for Geographic And Racial Differences in Stroke; Research Infrastructure; Resources; Rest; Risk; Risk Factors; Risk Reduction; Rural; Science; Sepsis; Shock; Societies; Stroke; Syndrome; Testing; Tobacco use; United States Agency for Healthcare Research and Quality; United States Health Resources and Services Administration; Vaccination; Variant; Vital Statistics; base; body system; cohort; design; geographic difference; injured; innovation; kidney infection; malignant breast neoplasm; microbial; mortality; population based; prevent; racial difference

DESCRIPTION (provided by applicant): Sepsis, a condition of enormous public health importance, has two-fold regional variation in mortality in the US, with the highest cluster in the Southeastern US. Few studies have had the large-scale, national, population-based design required to explain these regional variations. Our proposed study will capitalize on the infrastructure of the 30,000 subject REGARDS community-based cohort, which has the elements needed to identify individual and community-level sepsis risk factors and their mediating effects on regional sepsis variations. Our study will advance sepsis science by identifying individual and community-level factors amenable to risk reduction, potentially leading to strategies to prevent sepsis and reduce its high mortality. Our study objectives are 1) identify individual, family, community and societal/system healthcare factors associated with sepsis attack rates and case fatality, and 2) determine their mediating effects on regional sepsis variations. Sepsis is a dangerous syndrome of body-wide systemic inflammation triggered by microbial infection. Sepsis may injure vital organs, resulting in shock and death. Sepsis is a major community threat, resulting in over 750,000 hospitalizations and 215,000 deaths in the US annually - exceeding deaths resulting from acute myocardial infarction, lung cancer or breast cancer. Our recent study indicates a Southeastern US "belt" of two-fold excess sepsis mortality, reflecting almost 8,500 excess sepsis deaths annually. To understand the reasons for regional variations in sepsis mortality, a study must be able to identify the pre-hospital individual and community-level risk factors associated with sepsis attack rates and case fatality. However, few studies have had the large-scale, national, population-based design required to examine these relationships. We propose an ancillary study to the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, an ongoing NINDS-funded national cohort of >30,000 community-dwelling adults. Using the well- established infrastructure of this large cohort study, we will identify sepsis hospitalizations and deaths, drawing upon over 3,300 events across a 10-year span. We will test associations between baseline individual and community healthcare-related characteristics (resources, access and quality of care) and the risks of incident sepsis and 28-day sepsis death (case fatality), determining their mediating influences on regional sepsis variations. The specific aims of this study are to 1) Determine US geographic variations in sepsis susceptibility (attack rate) and case fatality, 2) Determine the individual and family characteristics that mediate sepsis geographic variations and 3) Determine the community and societal/system healthcare characteristics that mediate sepsis geographic variations. PUBLIC HEALTH RELEVANCE: Sepsis is a life-threatening condition consisting of body-wide inflammation triggered by infections such as pneumonia, kidney infection, cellulitis or meningitis. This study will determine if certain individuals or communities are prone to develop sepsis. Information from this study will support strategies to reduce or prevent sepsis in the community. .

描述（由申请人提供）：败血症是一种巨大的公共卫生重要性的条件，在美国的死亡率差异两倍，在美国东南部的群集最高。很少有研究对解释这些区域差异所需的大规模，国家，基于人群的设计。我们提出的研究将利用30,000个受试者的基础设施涉及社区的同类群体，该研究具有确定个体和社区级别的败血症风险因素及其对区域败血症变化的中介作用所需的要素。我们的研究将通过确定可降低风险的个体和社区级别的因素来推动败血症科学，这可能导致预防败血症并降低其高死亡率的策略。我们的研究目标是1）确定与败血症攻击率和病例死亡相关的个人，家庭，社区和社会/系统医疗保健因素，以及2）确定它们对区域败血症变化的中介作用。败血症是由微生物感染触发的全身炎症的危险综合征。败血症可能会伤害重要器官，导致冲击和死亡。败血症是一个主要的社区威胁，每年在美国导致超过750,000次住院和215,000人死亡 - 急性心肌梗塞，肺癌或乳腺癌导致死亡。我们最近的研究表明，美国东南部的“腰带”有两倍过多的败血症死亡率，每年反映了近8,500次过量的败血症死亡。要了解败血症死亡率区域变化的原因，一项研究必须能够确定与脓毒症攻击率和病例死亡相关的院前个体和社区级别的风险因素。但是，很少有研究需要研究这些关系所需的大规模，国家，基于人群的设计。我们提出了一项辅助研究，涉及中风（问起）的地理和种族差异的原因，这是一项持续的Ninds资助的全国人群，拥有> 30,000名社区居住的成年人。利用这项大型队列研究的良好基础设施，我们将确定败血症的住院和死亡，在10年的时间里有3300多个事件。我们将测试基线个人和社区医疗相关特征（资源，访问和护理质量）与事件败血症和28天败血症死亡（病例死亡）之间的关联，确定了它们对区域败血症变化的介导影响。这项研究的具体目的是1）确定败血症易感性（攻击率）和病例死亡的美国地理变化，2）确定介导脓毒症地理变化的个体和家庭特征，3）确定介导脓毒症地理变化的社区以及社区和社会/系统医疗保健特征。 公共卫生相关性：败血症是一种威胁生命的疾病，由肺炎，肾脏感染，纤维炎或脑膜炎等感染引发的身体范围炎症。这项研究将确定某些个人或社区是否容易发展败血症。这项研究的信息将支持减少或防止社区败血症的策略。 。