This K08 proposal will complete Hallie Prescott, MD; MSc's training towards her long-term career goal of improving the long-term survival and quality of life of critical illness survivors. Dr. Prescott is a pulmonary & critical care physician and scientist at the University of Michigan, with Master's training in clinical study design and biostatistics. This proposal builds on Dr. Prescott's prior experience, leveraging advanced statistical methods, granular clinical data, and the rich training environment at University of Michigan to improve our understanding and management of post-sepsis morbidity. The research will be completed under the guidance of primary mentor Theodore J. Iwashyna, MD, PhD, co-mentor Kenneth Langa, MD, PhD, and co-mentor Richard Gonzalez, PhD, with a planned mentor-the-mentor strategy and additional input from an advisory board of physician-scientists. This 5-year plan includes formal coursework, professional development, and mentored research, with defined milestones to ensure productivity and a successful transition to independence. This mentored research has 2 specific Scientific Aims:
AIM 1 : Test the relative importance 3 competing hypotheses for the general pathway of post- sepsis morbidity. * AIM 2: Develop a diagnosis-specific readmission risk profile tool to personalize treatment for severe sepsis survivors in the immediate (90-day) post-hospital setting. Inherent to completing these high-level Aims, Dr. Prescott will also (1) characterize the epidemiology of multi- morbidity and hospitalization in severe sepsis survivors, (2) identify the health conditions most increased after severe sepsis, (3) define the incremental benefits of specific clinical data in improving risk prediction, (4) compare the accuracy and usability of complementary cutting edge personalized prediction methodologies. This work will build to at least two R01 proposals: (1) to examine the mechanism by which a specific chronic health condition is increased after severe sepsis (as identified in Aim 1) or to examine how post-sepsis morbidity differs from that of less-severe infections and sterile inflammation, and (2) to implement and evaluate the diagnosis-specific risk profile tool developed in Aim 2. Beyond establishing the foundation for a programmatic line of research to improve the care of severe sepsis survivors, this proposal will provide Dr. Prescott with research skills that are readily applicable to additional domains of critical illness research In short, this K08 award will support and accelerate the career development activities of Dr. Prescott and allow her to successfully launch into the next phase of her career as an independent investigator.
Hundreds of thousands of Americans survive severe sepsis each year and face increased rates of hospitalization, co-morbid illness, and early death. Yet, we lack a unified understanding of how severe sepsis confers long-term morbidity, and have limited ability to identify those patients at greatest risk of specific adverse outcomes. Correctin these deficits, as proposed in this project, is of great public health importance to the large and growing population of severe sepsis survivors, as it offers the prospect of a more rapid recovery process, reduced health care needs, and better quality of life.
| Liu, Vincent X; Escobar, Gabriel J; Chaudhary, Rakesh et al. (2018) Healthcare Utilization and Infection in the Week Prior to Sepsis Hospitalization. Crit Care Med 46:513-516 |
| Royer, Stephanie; Prescott, Hallie C (2018) Reply to Azithromycin: Short Course with Long Duration. J Hosp Med 13:583 |
| Carlton, Erin F; Prescott, Hallie C (2018) Variation in Sepsis-Related Mortality; Implications for Performance Improvement. Crit Care Med 46:1871-1873 |
| Hensley, Matthew K; Prescott, Hallie C (2018) Bad Brains, Bad Outcomes: Acute Neurologic Dysfunction and Late Death After Sepsis. Crit Care Med 46:1001-1002 |
| Royer, Stephanie; DeMerle, Kimberley M; Dickson, Robert P et al. (2018) Shorter Versus Longer Courses of Antibiotics for Infection in Hospitalized Patients: A Systematic Review and Meta-Analysis. J Hosp Med 13:336-342 |
| Levy, Mitchell M; Gesten, Foster C; Phillips, Gary S et al. (2018) Mortality Changes Associated with Mandated Public Reporting for Sepsis. The Results of the New York State Initiative. Am J Respir Crit Care Med 198:1406-1412 |
| Prescott, Hallie C; Cope, Tara M; Gesten, Foster C et al. (2018) Reporting of Sepsis Cases for Performance Measurement Versus for Reimbursement in New York State. Crit Care Med 46:666-673 |
| Prescott, Hallie C; Angus, Derek C (2018) Enhancing Recovery From Sepsis: A Review. JAMA 319:62-75 |
| Meyer, Nathaniel; Harhay, Michael O; Small, Dylan S et al. (2018) Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis. Crit Care Med 46:354-360 |
| Prescott, Hallie C; Costa, Deena Kelly (2018) Improving Long-Term Outcomes After Sepsis. Crit Care Clin 34:175-188 |
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