The PREDICT Study (PRE-ICU Determinants of Post-ICU FunCTional Outcomes among Older Adults)

PREDICT 研究（ICU 前老年人 ICU 后功能结果的决定因素）

• 批准号: 10205952
• 负责人: Lauren Ferrante
• 金额: $ 21.74万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10205952
• 关键词: Address; Admission activity; Adult; Age; Aging; American; Award; Calibration; Capsicum; Career Choice; Caring; Cessation of life; Chest; Clinical; Clinical Trials; Clinical assessments; Cognitive; Country; Critical Care; Critical Illness; Data; Data Analyses; Data Collection; Dependence; Development Plans; Discrimination; Elderly; Elements; Emotional; Environment; Epidemiology; Event; Evidence based intervention; Geriatrics; Gills; Goals; Grant; Health; Home; Hospitals; Impaired cognition; Independent Living; Individual; Institutionalization; Intensive Care Units; Intervention; Knowledge; Longitudinal Studies; Lung; Mechanical ventilation; Medical; Medical Societies; Medical center; Medicine; Mentors; Mentorship; Morbidity - disease rate; Outcome; Outcomes Research; Patients; Physicians; Population; Prevention; Probability; Prospective cohort study; Provider; Public Health; Public Health Schools; Publications; Recovery; Reporting; Research; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Risk Assessment; Risk Factors; Scientist; Services; Shock; Sleep; Societies; Survivors; Testing; Training; Translating; United States; Validation; Work; acceptability and feasibility; adverse outcome; career; career development; clinical epidemiology; cohort; design; disability; experience; functional outcomes; hearing impairment; high risk; improved; improved outcome; innovation; longitudinal dataset; medical schools; medical specialties; mortality; patient oriented; predictive tools; programs; research and development; risk prediction; skills; success; survivorship; tertiary care; tool; trend; working group

PROJECT SUMMARY/ABSTRACT Candidate: My career goal is to become an independent physician-scientist and national leader in geriatric critical care outcomes research whose body of work improves the long-term functional outcomes of critically ill older adults. My clinical training as a Pulmonary & Critical Care Medicine (PCCM) physician and research training in Geriatric Clinical Epidemiology have prepared me to pursue this career path. My track record of early success is evidenced by the publication of high-impact original reports and the receipt of 3 grants, including a GEMSSTAR award. I have already distinguished myself as a national leader in my specialty as well as in geriatrics: I founded and am co-chair of the American Thoracic Society Critical Care Assembly's Aging and Geriatrics Working Group, and was recently selected as an incoming co-chair of the American Geriatrics Society (AGS) Medical Subspecialties Section. My research efforts have been recognized nationally, with the AGS New Investigator Award, and at Yale, with the prestigious Iva Dostanic Physician-Scientist Award. Mentors and Environment: I have an exceptional team of mentors and advisors, including my primary mentor Dr. Thomas Gill (Geriatrics), a leading expert on the epidemiology and prevention of disability, co-mentor Dr. Margaret Pisani (PCCM), an expert in critical care outcomes research, and advisor Dr. Terrence Murphy, a biostatistician with expertise in longitudinal studies of aging and critical care outcomes research. My research and career development plans draw on the wealth of resources available at Yale, including the Yale Program on Aging/Claude D. Pepper Older Americans Independence Center, the Yale School of Public Health, and one of the largest intensive care units (ICUs) in the country at Yale-New Haven Hospital. These resources, and the support provided by the Section of Pulmonary, Critical Care, and Sleep Medicine at the Yale School of Medicine, provide an ideal environment for my career development and execution of the proposed research. Mentored Research Project: Nearly 1.4 million older adults survive an ICU stay each year, and many of these will suffer from increased disability. Our prior work has demonstrated that premorbid factors are strongly associated with the course of disability after a critical illness – yet no mechanism exists to identify which older ICU patients are at risk of increased disability. To address this knowledge gap, I have proposed an innovative research project that leverages the wealth of resources available at Yale in addition to two high-quality longitudinal datasets: the National Health and Aging Trends Study (NHATS) and Precipitating Events Project (PEP). The overall objective is to develop, externally validate, and pilot test a predictive tool (that incorporates premorbid risk factors) to identify older ICU patients at risk of worsening post-ICU disability and provide a personal estimate of the increase in disability. The results will inform the design and conduct of a larger prospective cohort study to test the accuracy of the tool in predicting post-ICU disability as well as a subsequent clinical trial testing interventions to improve post-ICU functional outcomes among older adults.

项目摘要/摘要 候选人：我的职业目标是成为一名独立的医生-科学家和老年医学领域的国家领导人。 危重病护理结果研究，其工作主体改善危重病患者的长期功能结果 老年人我作为肺和重症监护医学（PCCM）医生和研究人员的临床培训 在老年临床流行病学的培训，我准备追求这一职业道路。我的跟踪记录， 早期的成功体现在出版了影响力大的原始报告和收到3笔赠款， 包括GEMSSTAR奖我在我的专业领域也已经成为国家领导人 就像老年医学一样：我创立了美国胸科学会重症监护大会的老龄化问题， 和老年医学工作组，最近被选为美国老年医学委员会的新任联合主席。 社会（AGS）医学专科科。我的研究成果得到了全国的认可， AGS新研究者奖，并在耶鲁大学，与著名的Iva Dostanic物理学家科学家奖。 导师和环境：我有一个优秀的导师和顾问团队，包括我的主要导师 博士托马斯吉尔（老年医学），流行病学和残疾预防方面的领先专家，共同导师博士。 Margaret Pisani（PCCM），重症监护结果研究专家，顾问Terrence Murphy博士， 生物统计学家，具有老龄化纵向研究和重症监护结局研究的专业知识。我的研究 和职业发展计划利用耶鲁大学的丰富资源，包括耶鲁计划 关于衰老/克劳德D.佩珀老年美国人独立中心，耶鲁大学公共卫生学院，以及一个 美国最大的重症监护病房（ICU）在耶鲁纽黑文医院。这些资源，以及 由耶鲁大学医学院肺部、重症监护和睡眠医学科提供的支持， 医学，为我的职业发展和执行拟议的研究提供了理想的环境。 指导研究项目：每年有近140万老年人在ICU中存活下来，其中许多人 将遭受更严重的残疾。我们先前的工作已经证明，发病前的因素是强烈的， 与重大疾病后的残疾过程相关-但没有机制确定哪些老年人 ICU患者的残疾风险增加。为了解决这一知识差距，我提出了一个创新的 该研究项目利用了耶鲁大学丰富的资源，除了两个高质量的 纵向数据集：国家健康和老龄化趋势研究（NHATS）和重大事件项目 （PEP）。总体目标是开发、外部验证和试点测试预测工具（包括 发病前危险因素），以确定老年ICU患者在ICU后残疾恶化的风险，并提供一个 个人对残疾增加的估计。研究结果将为一个更大规模的 前瞻性队列研究，以测试该工具在预测ICU后残疾方面的准确性， 随后的临床试验测试干预措施，以改善老年人ICU后的功能结局。