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 败血症被定义为威胁生命的器官功能障碍，这是由于宿主对感染反应失调的反应， 包含从败血症到严重败血症的连续体，败血性休克，多器官功能障碍 综合征（mod），有时未经治疗，有时死亡。败血症是全球儿童死亡率的主要原因， 这些死亡大多数发生在低收入和中等收入国家（LMIC）。气候变化紧密 与传染病有关，这会导致一部分患者的败血症；例如，温度升高， 增加洪水，干旱和变化的栖息地可能会使生态平衡兴奋不已，鼓励感染力 疾病传播和触发暴发，例如启动子和腹泻和呼吸道 疾病。那些生活在世界上最贫穷的社区，尤其是儿童和年龄较大的人，可能会 受气候感染感染疾病的升级，遭受最大的痛苦。但是，dospite既更大 在这些情况下，败血症儿童死亡率较高的脆弱性，有一个 文献对气候变化对LMICS中败血症和败血症结果的影响很少。尤其， 孟加拉国已被确定为世界上最脆弱的国家之一，危害气候变化威胁。 拟议的研究将建立与气候变化和健康有关的其他目标 研究，“为儿科患者开发移动健康个性化生理分析工具 败血症”（R21 TW012211）。我们将评估气候趋势对小儿脓毒症事件的影响 使用从父母研究中收集的脓毒症患者的父母研究的数据和死亡率 重症监护室国际腹泻病研究中心，孟加拉国（ICDDR，b）达卡 医院以及所有被诊断为脓毒症的儿科患者的电子健康记录（EHR）数据 ICDDR，B达卡医院。从这项研究中获得的知识将大大提高证据基础 气候和气候趋势变化对孟加拉国败血症患病儿童的影响，这可能是 适用于其他类似的LMIC设置。这项工作也有可能改善临床预测 我们正在创造的败血症严重程度和死亡风险的模型，从而告知临床医生 个人护理的气候。拟议的计划还将建立技术和专业的基础 罗德岛医院和ICDDR的专业知识，B在气候变化和健康研究方面，这将允许未来 研究和合作研究气候变化对败血症和传染病的影响。 关于气候和败血症相交的相交的研究，特别是在儿童中，可能使研究人员， 临床医生和政策制定者最好计划如何加强医疗保健系统，更好地分配稀缺人类 以及物质资源以及发展干预措施，以支持患者和社区适应和 减轻这些公共卫生威胁。