研究HIV感染者骨折風險模型的新獎項 | 耶魯大學護理學院

事實證明,艾滋病毒感染者的脆性骨折發生率高於未感染者,並導致全國範圍內每年超過9900萬美元的超額費用。

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  In people living with HIV, the disease itself, along with medications to treat the infection can cause long term side effects. Fragility fractures have been shown to occur at a higher rate in persons with HIV, than in their uninfected counterparts and has led to over $99M in excess costs annually nationwide. 

  Yale School of Medicine and Yale School of Nursing researchers have been awarded a new R01 grant to develop, validate, and disseminate a risk assessment tool to predict fragility fractures in persons with HIV.

  “These fractures are associated with increased rates of hospital and nursing home admissions, along with long-term physical disability, social isolation, and death,” said co-PI Evelyn Hsieh, MD, PhD, assistant professor of medicine (rheumatology, allergy and immunology) at Yale School of Medicine; and chief of rheumatology at VA Connecticut Healthcare. “We know that most of these fractures occur in middle age, so they can also cause economic hardship and poor health outcomes as these patients age.”

  Associate Professor of Nursing at Yale School of Nursing Julie Womack, PhD, CNM, FNP-BC, serves as co-PI with Donroe on the study. “Because of the numerous ramifications of these fractures, we are setting out to create and test a risk assessment tool based on the Fracture Risk Assessment Tool (FRAX) that will incorporate the HIV-relevant risks into the model.”

  While FRAX includes demographic information and key risk factors for a general population, it does not account for additional factors that are important for people with HIV, such as falls, co-infections including hepatitis C and B, substance use disorders, polypharmacy, and more said Hsieh.

  The team will create a Fracture Risk Assessment Calculator, based on FRAX, but that incorporates HIV-relevant risk factors (FRAC-HIV) to calculate the probability of a fracture within the next year. They will use data from the Veterans Aging Cohort Study to develop the model, and will validate the tool using electronic health record data from Yale New Haven Health and Boston University School of Medicine.

  Awarded by the National Institutes of Health, the five-year grant for $2,425,731 began in July 2021 and runs through June 2026.

Other collaborators include Yale School of Medicine’s Amy Justice, MD, PhD; Cynthia Brandt, MD, MPH; Samah Fodeh, PhD; Terrence Murphy, PhD; Farah Kidwai-Khan; Linda Leo-Summers; Rixin Wang, PhD; F. Perry Wilson, MD, MSCE; and Claudia Coronel-Moreno. 

Boston University School of Medicine contributors include Richard Saitz, MD, MPH, FACP, DFASAM; William Adams; and Kara Magane.

全文翻譯(僅供參考)

  對於HIV感染者來説,疾病本身以及治療感染的藥物會造成長期的副作用。事實證明,艾滋病毒感染者的脆性骨折發生率高於未感染者,並導致全國範圍內每年超過9900萬美元的超額費用。

  耶魯大學醫學院和耶魯大學護理學院的研究人員獲得了一項新的R01撥款,用於開發、驗證和傳播一種風險評估工具,以預測艾滋病患者的脆性骨折。

  "耶魯大學醫學院醫學(風濕病學、過敏學和免疫學)助理教授、醫學博士Evelyn Hsieh説:"這些骨折與住院和療養院入住率的增加有關,還有長期的身體殘疾、社會隔離和死亡。"我們知道這些骨折大多發生在中年時期,因此隨著這些患者年齡的增長,它們也會造成經濟困難和健康狀況不佳"。

  耶魯大學護理學院護理學副教授Julie Womack, PhD, CNM, FNP-BC, 與Donroe一起擔任這項研究的共同參與人。"由於這些骨折的影響眾多,我們正著手在骨折風險評估工具(FRAX)的基礎上創建和測試一個風險評估工具,該工具將把HIV相關的風險納入模型。

  雖然FRAX包括一般人群的人口資訊和關鍵風險因素,但它沒有考慮到對HIV感染者很重要的額外因素,如跌倒、包括丙型肝炎和乙型肝炎在內的合併感染、藥物使用障礙、多種藥物等等,謝説。

  該團隊將在FRAX的基礎上創建一個骨折風險評估計算器,但將HIV相關的風險因素納入其中(FRAC-HIV),以計算未來一年內發生骨折的概率。他們將使用退伍軍人老齡化隊列研究的數據來開發該模型,並將使用耶魯大學紐黑文醫院和波士頓大學醫學院的電子健康記錄數據來驗證該工具。這項由美國國立衛生研究院頒發的為期五年的撥款為2,425,731美元,從2021年7月開始,一直持續到2026年6月。

  其他合作者包括耶魯大學醫學院的Amy Justice博士、Cynthia Brandt博士、Samah Fodeh博士、Terrence Murphy博士、Farah Kidwai-Khan、Linda Leo-Summers、Rixin Wang博士、F. Perry Wilson博士、MSCE博士以及Claudia Coronel-Moreno。

  波士頓大學醫學院的貢獻者包括Richard Saitz, MD, MPH, FACP, DFASAM; William Adams; 和Kara Magane。

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