Focus Areas and Research Objectives
Understanding the causes of sepsis: understand the pathogenesis and the social determinants of sepsis, and the complex interplay between diabetes, obesity, and sepsis.
Sepsis Canada supports research that reduces the burden of sepsis for Canadians. Specifically, Sepsis Canada supports research projects led by three research teams:
- Team 1 focuses on Population Health, Economics and Policy
- Team 2 focuses on Advocacy, Knowledge Transfer and Education
- Team 3 focuses on Translational Biology, Clinical Trials and Rehabilitation
These three teams ensure that Sepsis Canada advances the following six focus areas and their respective research objectives.
Understanding the causes of sepsis: understand the pathogenesis and the social determinants of sepsis, and the complex interplay between diabetes, obesity, and sepsis.
Improving the prevention of sepsis: Advance the primary and secondary prevention of sepsis.
Improving the detection and identification of sepsis: Ensure sepsis cases are identified and managed early. Understand the epidemiological and economic burden of sepsis in Canada; Ensure homogenous sepsis surveillance at the population level across Canada.
Improving the management of sepsis: Advance evidence-based management of sepsis and improve patient health outcomes.
Improving the rehabilitation and recovery from sepsis: Strategic objective coming soon.
Educating the next generation: Train the current and next generation of sepsis researchers, clinicians, support personnel and patient partners.
Little is known about the burden of sepsis in Canada. A fundamental factor is the ongoing debate on 'what is sepsis?'. Clinicians struggle to identify it; moreover, clinical identification of infection has a false-positive rate >40%. The various iterations of the consensus definition since the mid 1990s indicate diagnostic uncertainty and evolving conceptualization. Team 1 will work to resolve 4 key issues: (1) uncertainty about the population incidence of sepsis; (2) inadequate knowledge about risk factors and outcomes; (3) heterogeneity and limited accessibility of sepsis datasets distributed throughout the country; and (4) lack of knowledge on the economic consequences of sepsis.
Projects 1, 2 and 3 create infrastructure to study the clinical epidemiology of sepsis. Project 4 illustrates the value of these core infrastructures, evaluating the links between sepsis, and diabetes and obesity. Project 5 builds infrastructure necessary to understand the societal economic losses attributable to sepsis, and to identify populations in whom interventions would maximize health gains and cost savings for society.
Projects
- Project 1: Improving the Identification of Sepsis
- Project 2: Creation of a Metadata Catalog and Platform for Sepsis Epidemiology Studies
- Project 3: Scoping Review and Cataloguing of Existing Knowledge about the Epidemiology of Sepsis
- Project 4: The Impact of Diabetes on Sepsis-Associated Clinical Outcomes
- Project 5: The Economic Costs of Sepsis
Team 1 Leads/Mentors
Population-level and systems-based solutions are required for primary (prevention of infection), secondary (early recognition and treatment) and tertiary (in-hospital and post-hospital) management of sepsis. Team 2 will improve sepsis awareness and surveillance across Canada. Project 6 will improve pre-hospital recognition and post-hospital management of sepsis through a national knowledge translation campaign. The knowledge translation campaign will educate and inform the public and healthcare providers about sepsis, optimize detection and early treatment and enhance the functional recovery of patients with sepsis by recognizing and addressing the sequelae of their acute illness. This campaign is designed to be scaled and maintained, integrating scientific excellence with participation from patients, family members, clinicians, health system delivery organizations and non-governmental organizations. Project 7 will identify barriers and facilitators for improving early recognition and management of sepsis among paramedics and in Canadian EDs to design and evaluate knowledge translation interventions and test a bundle of care relevant for these health professionals.
Projects
- Project 6: Creating a Culture of Sepsis Awareness Through Advocacy, Health Literacy and Knowledge Translation
- Project 7: Addressing Gaps in Sepsis Care With Paramedics and Emergency Department Staff
- Project 8: Sepsis Canada Interdisciplinary Training Program
Team 2 Leads/Mentors
We currently categorize and triage septic patients based on a clinical syndromic classification. Tools include clinical severity scores such as SOFA (Sequential Organ Failure Assessment), early warning scores and blood lactate levels. While these are measures of overall severity, experts believe that this approach fails to distinguish between patients who require different therapies. Recent evidence suggests that sepsis may be subdivided into subgroups (endotypes) and that these subgroups have different prognosis, risks, and responses to therapy.
More tools are required to understand sepsis heterogeneity. Emulating advances made in oncology, we will build a research pipeline integrating translational research projects that will create these new tools, and clinical research evaluating the performance of more personalized interventions and protocols. Information will flow from translational to clinical research, and vice versa. For example, we aim to capitalize on existing and future clinical trials to build the Sepsis Canada Biobank. In turn, endotypes emerging from translational research projects will be fed into the design of clinical trials in a way that enables the evaluation of personalized therapeutic strategies.
Project 9, another infrastructure project, will create a platform in support of future clinical trials informed by emerging endotypes. Project 10 consists of an infrastructure plan to accelerate the discovery of sepsis endotypes from preclinical and clinical studies.
Projects
- Project 9: Canadian Clinical Research Network and Biorepository
- Project 10: National Preclinical Sepsis Platform