Development of a Mobile Health Personalized Physiologic Analytics Tool for Pediatric Patients with Sepsis

为脓毒症儿科患者开发移动健康个性化生理分析工具

• 批准号: 10671864
• 负责人: Adam Carl Levine
• 金额: $ 12.3万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-10 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10671864
• 关键词: Bangladesh; Cessation of life; Child; Child Mortality; Climate; Clinical; Collaborations; Communicable Diseases; Communities; Country; Critically ill children; Data; Development; Diagnosis; Disease Outbreaks; Droughts; Elderly; Electronic Health Record; Equilibrium; Floods; Functional disorder; Habitats; Healthcare Systems; Hospitals; Human; Immune response; Incidence; Infection; Intensive Care Units; Intervention; Knowledge; Lead; Life; Link; Literature; Multiple Organ Failure; Organ; Outcome; Parents; Patient Care; Patients; Physiological; Policy Maker; Public Health; Research; Research Personnel; Resources; Respiratory Disease; Rhode Island; Sepsis; Septic Shock; Severities; Temperature; Work; analytical tool; base; climate change; climate impact; climate-related health; diarrheal disease; disease transmission; enteric infection; evidence base; improved; individual patient; international center; low and middle-income countries; mHealth; mortality; mortality risk; patient subsets; pediatric patients; pediatric sepsis; predictive modeling; trend

Project Summary Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, encompasses a continuum that ranges from sepsis to severe sepsis, septic shock, multiple organ dysfunction syndrome (MODS) and eventually death if untreated. Sepsis is the leading cause of child mortality worldwide, with most of these deaths occurring in low and middle-income countries (LMICs). Climatic changes are closely linked to infectious diseases, which lead to sepsis in a subset of patients; for instance, rising temperatures, increased flooding, and droughts, and changing habitats may tip the ecological balance, encouraging infectious disease transmission and triggering outbreaks, such as enteric infections and diarrhea and respiratory diseases. Those living in the world’s poorest communities, particularly children and the elderly, are likely to suffer the most from escalations in climate-susceptible infectious diseases. However, despite both the greater vulnerability to climate change and the higher rates of child mortality from sepsis in these settings, there is a paucity of literature on the effects of climate change on sepsis and sepsis outcomes in LMICs. In particular, Bangladesh has been identified as one of the most vulnerable countries in the world to climate change threats. The proposed research will build additional aims related to climate change and health onto the parent R21/R33 study, “Development of a Mobile Health Personalized Physiologic Analytics Tool for Pediatric Patients with Sepsis” (R21 TW012211). We will evaluate the impact of climate trends on pediatric sepsis incidence, severity and mortality rate using data collected from the parent study of pediatric patients with sepsis admitted to the intensive care unit the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Hospital, as well as electronic health record (EHR) data from all pediatric patients diagnosed with sepsis at the icddr,b Dhaka Hospital. Knowledge gained from this study will greatly advance the evidence base for the impact of climate and changing climate trends on critically ill children with sepsis in Bangladesh which may be applicable to other similar LMIC settings. This work also has the potential to improve the clinical prediction models for sepsis severity and risk of death that we are creating, and thereby inform clinicians of the impacts of climate on individual patient care. The proposed initiatives will also build a base of technical and professional expertise at Rhode Island Hospital and icddr,b in climate change and health research which will allow future research and collaborations to study the impacts of climate change on sepsis and infectious diseases. Increased research on the intersection of climate and sepsis, particularly in children, may allow researchers, clinicians and policy makers to best plan how to strengthen healthcare systems, better allocate scarce human and material resources, and develop interventions to support patients and communities in adapting and mitigating these public health threats.

项目摘要 脓毒症，定义为由于宿主对感染的反应失调而导致的危及生命的器官功能障碍， 包括从脓毒症到严重脓毒症、感染性休克、多器官功能障碍的连续体 综合征(MODS)，如果不治疗，最终会死亡。脓毒症是全球儿童死亡的主要原因， 其中大部分死亡发生在低收入和中等收入国家。气候变化是密切相关的 与传染病有关，这会导致一部分患者出现败血症；例如，气温上升， 更多的洪水、干旱和栖息地的变化可能会破坏生态平衡，鼓励传染 疾病传播和引发暴发，如肠道感染、腹泻和呼吸道 疾病。那些生活在世界上最贫穷的社区的人，特别是儿童和老年人，可能会 易受气候影响的传染病升级的影响最大。然而，尽管这两个更大的 对气候变化的脆弱性和较高的儿童败血症死亡率在这些环境中，有一个 关于气候变化对脓毒症的影响以及LMICs败血症结局的文献很少。特别是， 孟加拉国已被确定为世界上最容易受到气候变化威胁的国家之一。 拟议的研究将在母公司R21/R33上建立与气候变化和健康相关的额外目标 研究报告《为儿童疾病患者开发移动健康个性化生理分析工具》 脓毒症“(R21 TW012211)。我们将评估气候趋势对儿童脓毒症发病率、严重程度的影响 和死亡率使用从父母研究中收集的儿童败血症患者入院的数据 国际腹泻病研究中心重症监护室，孟加拉国(ICDDR，b)达卡 医院，以及所有在医院被诊断为败血症的儿科患者的电子健康记录(EHR)数据 达卡医院ICDDR。从这项研究中获得的知识将极大地促进 气候和气候变化趋势对孟加拉国患有败血症的危重儿童的影响 适用于其他类似的LMIC设置。这项工作也有可能提高临床预测能力。 我们正在建立的脓毒症严重性和死亡风险的模型，从而使临床医生了解 个别病人护理的环境。拟议的举措还将建立一个技术和专业基础 罗德岛医院和ICDDR，b在气候变化和健康研究方面的专业知识，这将使未来 研究和合作研究气候变化对脓毒症和传染病的影响。 增加对气候和脓毒症交集的研究，特别是对儿童的研究，可能会让研究人员， 临床医生和政策制定者最好规划如何加强医疗系统，更好地分配稀缺的人力 和物质资源，并制定干预措施，以支持患者和社区适应和 缓解这些公共卫生威胁。