Incidence & Outcomes of SSI After Breast Cancer Surgery

描述(申请人提供)：这个职业发展奖(K01)是一项建议，旨在通过授课课程和与从传染病到经济学和健康行为研究等不同领域的主要导师和多学科专家的接触，进一步加强我在高级生物统计学、计量经济学和健康结果研究方面的教育和培训。这一高级培训的目标是获得全面研究乳腺癌手术后手术部位感染(SSI)的流行病学和结果所需的知识和技能，这种感染在美国每年可能影响多达18,000名妇女。前瞻性纵向队列设计将用于确定保乳手术、乳房切除和乳房切除术后1年内SSI的准确发生率和危险因素。SSI的临床结果，包括随后的进一步手术干预、抗生素给药和抗生素耐药性的发展，将利用住院和门诊随访数据进行评估。SSI对总体健康相关的生活质量、抑郁症状、性功能以及与愈合的乳房切口相关的具体问题的影响将在手术后多次评估。从社会角度来看，可归因于不同类型乳房手术的SSI的经济成本将使用住院和门诊就诊获得的财务数据进行量化。在生物统计学方面接受的高级培训将允许创建详细的统计模型，以计算住院和门诊环境中SSI的可归因性成本。在外科人群中确定SSI的准确发病率和特定危险因素将有助于风险分层指数和感染控制干预措施的发展，以预防乳腺癌手术后的这些感染。

DESCRIPTION (provided by applicant): This Career Development Award (K01) is a proposal to further my education and training in advanced biostatistics, econometrics, and health outcomes research through didactic courses and contact with a primary mentor and multidisciplinary group of experts in diverse fields ranging from infectious diseases to economics and health behavior research. The goal of this advanced training is to acquire the knowledge and skills necessary to comprehensively study the epidemiology and outcomes of surgical site infections (SSI) after breast cancer surgery, that may impact as many as 18,000 women each year in the United States. A prospective longitudinal cohort design will be used to determine accurate incidences and risk factors for SSI within 1 year after breast-conserving surgery, mastectomy, and mastectomy with immediate reconstruction. Clinical outcomes of SSI, including consequent further surgical interventions, antibiotic administration, and development of antibiotic resistance will be measured utilizing inpatient and outpatient follow-up data. The impact of SSI on overall health-related quality of life, depressive symptoms, sexual functioning, and specific issues related to the healing breast incision will be assessed multiple times after surgery. From the societal perspective, the economic costs attributable to SSI following the different types of breast surgery will be quantified using financial data obtained from inpatient hospitalizations and outpatient clinic visits. The advanced training received in biostatistics will allow for the creation of detailed statistical models to calculate the attributable costs of SSI in both the inpatient and outpatient setting. Determining accurate incidences and identification of specific risk factors for development of SSI in this surgical population will facilitate the development of risk stratification indices and infection control interventions to prevent these infections following breast cancer surgery.