# The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU Study

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2021 · $453,392

## Abstract

Project Summary/Abstract
 Cognitive skills are the crucial abilities required to manage money, maintain employment, and live
independently. Long-term cognitive impairment (LTCI) is a disabling loss of these skills that can persist for
months to years. LTCI frequently occurs after primary brain injury (e.g., traumatic brain injury, hypoxia), but
older LTCI research has not characterized primary brain injury using NIH Common Data Elements in Imaging,
the contributions of polytrauma, and the time-course of the critical illness, including secondary brain injury (i.e.,
delirium). In our recent large study of ICU patients without primary brain injury, over 50% of patients had LTCI
and nearly 50% were newly unemployed at one-year post-discharge. In-hospital delirium was the major
independent risk factor for LTCI. Surprisingly, this delirium-related LTCI was similar to the LTCI seen in past
studies after moderate traumatic brain injury. Thus, both primary and secondary brain injury are associated
with LTCI, yet they have not been studied together. There is an unmet need to define the independent risks of
primary brain injury and delirium in LTCI. The trauma ICU patient is at combined risk for primary brain and/or
multisystem injuries, secondary brain injury, and critical illness; these critically injured patients are the unique
population to address this knowledge gap. Therefore, our FIRST HYPOTHESIS is that delirium duration is an
independent risk for the severity of LTCI, controlling for confounders of co-morbidities, socioeconomic status,
pre-injury employment, primary brain injury, polytrauma, and critical illness. AIM 1 will address this hypothesis
by defining the independent risks of primary and secondary brain injury on the severity of LTCI among 900
trauma ICU subjects. But, LTCI's real-world impact on employment has not been explained or adjusted for the
above confounders and social factors. Accordingly, our SECOND HYPOTHESIS is that LTCI severity is an
independent risk for lower level of employment, adjusting for similar confounders. AIM 2 will delineate the
independent risk of LTCI severity on employment among trauma ICU survivors. Lastly, LTCI pathogenesis may
be related to persistent inflammation. So, our THIRD HYPOTHESIS is that hospital discharge biomarkers of
persistent inflammation will be independent risks for LTCI severity, adjusting for similar confounders. AIM 3 will
explore the mechanistic role of plasma inflammatory biomarkers on LTCI severity among trauma ICU survivors.

## Key facts

- **NIH application ID:** 10114906
- **Project number:** 5R01GM120484-05
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Mayur B Patel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $453,392
- **Award type:** 5
- **Project period:** 2017-01-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10114906

## Citation

> US National Institutes of Health, RePORTER application 10114906, The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU Study (5R01GM120484-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10114906. Licensed CC0.

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