Research Area: A Risk assessment and sepsis control; Overarching project
Project Number: A3.4
Duration: 30.09.2013 - 31.07.2015
Sepsis is a leading cause of both morbidity and mortality associated with very high costs of care. Growing evidence (Vachharajani, 2008; Akinnusi et al., 2008) suggests that increased morbidity of sepsis is associated with severe forms of obesity in critically ill patients. In contrast, recent analyses also underlined that patients who are overweight or obese have improved survival both 30 days and one year after intensive care unit (ICU) admission (e.g. Abhyankar et al., 2012). This observation has been called “obesity paradox” (Wurzinger et al., 2010) which means that obesity is a risk factor for developing sepsis but may be protective for subsequent clinical (mortality) outcomes. Given the still increasing number of obese individuals even in Germany (e.g. http://www.degs-studie.de/ cited in Richter-Kuhlmann, 2012), studying links between sepsis and metabolic alterations at various data levels along the bridge from “bench” to “bedside” on three levels (a) Molecular epidemiology, b) Clinical epidemiology and c) Clinical trials; Figure 1) will be the focus of SepsiMet. This point is further underlined by the very limited knowledge on biological mechanisms (for a review see Vachharajani, 2006) on sepsis in obese critically ill patients. At the level of clinical studies, severely obese patients are often explicitly excluded so that conclusions from these trials may not generalize to severely obese patients.
In general, the professorship for Clinical Epidemiology will be one of a few positions in Germany working in both the fields of basic and applied research. As such it may contribute to an understanding of why a large amount of basic science results are either not reproducible or do not translate into clinical benefits (Ioannidis, 2005ab; Contopoulos-Ioannidis et al., 2008; Begley and Ellis, 2012). This is sometimes referred to as “translational epidemiology” (Khoury et al., 2010).