Pittsburgh Surgical Outcomes Research Center
Transforming the conduct of clinical research

Critical Care

Predictors of Complicated Clostridium difficile Infection

An analysis of all patients at UPMC Presbyterian Shadyside over the past 10 years to develop a demographic profile of patients with Clostridium difficile infection, as well as to identify predictors of a complicated disease course. The study will also include the development of computable phenotypes of disease (phekb.org) for both routine and complicated Clostridium difficile infection.

Red-Cell Storage Duration and Ventilator-Associated Pneumonia in Mechanically Ventilated Medical Intensive Care Unit Patients

This will be a retrospective, single-center observational study of patients admitted to the UPMC Presbyterian Medical Intensive Care Unit over a 5-year period. Adult patients (i.e., >18 years of age) who are mechanically ventilated for at least 48 hours and received at least one unit of packed red blood cells will be cross-referenced with reported infection control data and relevant Central Blood Bank data (e.g., storage duration, whether leukoreduced) by a third-party to create a single data set.

Epigenetic changes from trauma

People sustaining trauma have distinct recovery and non-recovery clinical trajectories, a difference that is incompletely explained by subject characteristics or the magnitude of injury. Recent data suggest that the non-recovery of trauma is the consequence of underlying changes within the genetic landscape of the immune system. This prospective study seeks to address the following hypothesis: There is a correlation between epigenetic changes of the immune stem cell within the bone marrow and the clinical phenotype and trajectory of persons sustaining trauma.

Light therapy in acute appendicitis,diverticulitis, pneumonia and sepsis

Our murine studies suggest that exposure to blue (480nm) light, by comparison to ambient white or amber (580nm) light, reduces the inflammatory response (i.e., cytokine concentration), risk of organ failure (i.e., kidney failure), and improves the clearance and control of the infectious focus (i.e., reduced abdominal and pulmonary bacterial counts and bacterial dissemination into tissues of the liver and spleen) in mice subjected to a model of cecal ligation and puncture (CLP) or a model of pneumonia. These data directly support the proposed project and experimentation.

Assessment Of Endotypes Of Thrombocytopenia In Critically Ill Patients And Creation Of Modeling Strategies For Predicting Diagnostics And Outcomes Related To Thrombocytopenia In The Intensive Care Unit.

Thrombocytopenia is incredibly common in the ICU but can have numerous causes.  Diagnostic testing for related conditions such as heparin-induced thrombocytopenia can be expensive and result in inappropriate alterations in care.  Using a collaborative approach with engineers at the University of Pittsburgh, we are conducting large scale modeling of databases of critically ill patients to define endotypes of thrombocytopenia and better understand the clinical variables related and how to best identify the source of thrombocytopenia in the critically ill patient.

Sepsis restructures immune cells

Each year, at least 1.7 million Americans develop sepsis (previously ‘severe sepsis’), of which 270,000 will die. Globally sepsis afflicts 19 million people and incurs 5 million deaths. In the US, it is present in 6% of adult hospitalizations and causes 1 in 3 in-hospital deaths. With a case fatality rate of 15.6%, it is the 10th leading cause of death.

Light and Critical Illness

A translational project using both murine models and human clinical interventional trials to explore the biological and clinical effects (e.g., organ injury, mortality) of light spectral therapy for the treatment of sepsis and traumatic.