Utilizing publicly available data to improve long-term quality of life following pediatric sepsis while fostering a new generation of sepsis investigators

项目总结/文摘

PROJECT SUMMARY/ABSTRACT Community-acquired septic shock is a major cause of death among children and often leads to poor long-term health-related quality-of-life (HRQL) among survivors. Long-term HRQL following pediatric septic shock may be affected by many baseline and clinical factors that have not yet been adequately investigated. The long-term goal of this research is to improve outcomes from pediatric community-acquired septic shock. The overall objective is to identify modifiable factors related to the clinical course of children with septic shock as well as pre- existing child or environmental factors that may impact long-term morbidity and mortality. The central hypothesis is that identifiable, modifiable factors during pediatric community-acquired septic shock may affect the risk of long-term morbidity and mortality among children encountering septic shock, as well as the risk of family dysfunction and psychological distress among their caregivers. The expected outcomes of the research are new knowledge about factors contributing to adverse child and family outcomes following pediatric septic shock. This new knowledge will have a positive impact because it will provide an evidence-base for the development and testing of new interventions targeted at modifiable factors. The specific aims of this project are Aim 1) Identify baseline characteristics that are associated with impaired long-term functional status and health-related quality of life among children following community-acquired septic shock. Aim 2) Identify aspects of the clinical course that are associated with impaired long-term functional status and health-related quality of life among children following community-acquired septic shock. Aim 3) Identify factors associated with long-term family functioning and psychological distress of the primary caregiver following their child’s hospitalization for community-acquired septic shock. The approach to address these aims is to collaborate with junior investigators and their local mentors from several academic institutions to answer important questions about pediatric sepsis using a publicly available dataset from the NIH-funded Life After Pediatric Sepsis Evaluation (LAPSE) study. Junior investigators will be provided with complete biostatistical support and additional mentorship from experts in pediatric sepsis and the LAPSE study. This contribution is significant because it will provide an evidence basis for designing definitive clinical trials and developing clinical protocols that address modifiable factors to optimizing care and improving long-term child and family outcomes following septic shock. The research proposed is innovative because it will result in a substantial departure from the status quo by introducing junior investigators to the benefits of using established public use databases and providing them with an educational experience in their use.