Identifying pre-sepsis opportunities for early, targeted intervention

项目总结 据估计，全世界每年有600万人死于脓毒症。脓毒症还导致高达50%的 美国医院死亡人数。早期治疗是全世界公认的改善脓毒症的唯一可修改因素 死亡率。因此，目前的治疗指南主要集中在医院后立即进行的早期脓毒症护理。 演示文稿。然而，主要的国家和全球卫生当局也强调有必要确定甚至 院前早期预测、识别或治疗败血症的机会。人们对这场演讲知之甚少， 败血症前期患者的感染速度和概况。了解这些特征可以使小说 院前方法旨在减轻甚至预防脓毒症。使用创新的翻译 信息学方法，该项目将识别和表征早期、有针对性的脓毒症前机会 干预。为了实现这一目标，我的实验室利用了全面的电子病历数据， 先进的信息学方法，以及对新护理计划的评估。通过这项提议，我们将 开发和验证预测模型，以确定普通院前环境中风险最高的患者 即将发生的脓毒症、器官衰竭和死亡。在这个过程中，我们将描述与脓毒症相关的 预示不良后果风险最高的症状特征。调查结果将产生广泛而直接的影响 对患者、临床医生和卫生系统的影响。这些结果也将为脓毒症的设计提供参考。 公共卫生计划和未来的随机临床试验旨在改善这一毁灭性的结果 条件。

PROJECT SUMMARY Sepsis kills an estimated 6 million people worldwide every year. Sepsis also contributes to as many as 50% of US hospital deaths. Early treatment is the only universally recognized modifiable factor for improving sepsis mortality. Thus, current treatment guidelines focus heavily on early sepsis care immediately following hospital presentation. However, key national and global health authorities also emphasize the need to identify even earlier pre-hospital opportunities to predict, recognize, or treat sepsis. Little is known about the presentation, pace, and profile of infection in pre-sepsis patients. Understanding these characteristics could enable novel pre-hospital approaches designed to mitigate, or even prevent, sepsis. Using an innovative translational informatics approach, this project will identify and characterize pre-sepsis opportunities for early, targeted intervention. To achieve this goal, my laboratory leverages comprehensive electronic medical record data, advanced informatics methods, and the evaluation of novel care programs. Through this proposal, we will develop and validate prediction models that identify patients in common pre-hospital settings at the highest risk of impending sepsis, organ failure, and mortality. In the process, we will characterize the sepsis-related symptom profiles that portend the highest risk of adverse outcomes. Findings will have broad and immediate implications for patients, clinicians, and health systems. These results will also inform the design of sepsis public health programs and future randomized clinical trials aimed at improving outcomes for this devastating condition.