Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating form of stroke, striking relatively young individuals and carrying a mortality rate of almost 40 percent. About 30 percent of those who do survive will experience severe long-term disability and require skilled care for the remainder of their lives. Ansley Grimes Stanfill, PhD, RN, assistant professor in the Department of Advanced Practice and Doctoral Studies at the University of Tennessee Health Science Center was recently awarded over $1.1 million to study how social, clinical, and genetic factors affect one’s risk for developing severe disability after subarachnoid hemorrhage, aiming to also give insight into the disparities for this outcome seen between Caucasian and African- American patients.
“African Americans are disproportionately affected by aSAH, are affected at a younger age (often under 40 years old), and are at greater risk for severe disability compared to Caucasians,” Dr. Stanfill said. “There is a critical gap in our knowledge related to predictive factors for long-term disability outcomes in both populations and factors contributing to the observed disparities in African Americans. Additionally, the lack of such knowledge presents a fundamental roadblock for developing an individualized intervention to reduce disability and increase patients’ quality of life after aneurysmal subarachnoid hemorrhage.”
With a background as a bedside critical care, neurology, and neurosurgery nurse and guided by strong pilot data, Dr. Stanfill and her research team aim to develop a multivariate model encompassing social, clinical, and genetic factors which they hypothesize will provide a sensitive and specific prediction of 12-month disability outcomes for Caucasians and African Americans. They are also looking to evaluate whether, and to what degree, racial differences influence the prediction of outcomes.
“To test this, we will build two multivariate models that will add genetic data from candidate pathways to already existing longitudinal social and clinical aSAH databases; one using data from Caucasian subjects at the University of Pittsburgh, and the other using data from African American subjects at the Semmes Murphey Clinic in Memphis,” Dr. Stanfill said. “After validation and cross-validation, the uniformity of the two models will be compared for insights into factors contributing to the racial disparities seen for outcomes.”
According to Dr. Stanfill, the work will have a “significant impact because it is expected to advance and expand our understanding of possible factors related to long-term disability and the disparate outcomes seen in these two races. Lack of such knowledge hinders the development of critically needed individualized and multidimensional intervention approaches to reduce post-stroke disability and improve outcomes.”
The preliminary data supporting Dr. Stanfill’s new research project was stimulated by a Collaborative Research Network (CORNET) Award she received in 2016 from the UTHSC Office of Research. Launched in 2016 by Steven R. Goodman, PhD, vice chancellor for Research at UTHSC, the CORNET Awards program promotes new lines of team-based research and serves as a catalyst of new collaborative partnerships that cross UTHSC college boundaries, UT System campuses, state lines, and beyond with the ultimate goal of recipients receiving extramural funding. The CORNET Awards program has granted over $1.4 million in seed funding to over 30 collaborative research teams, with projects ranging in topic from cancer to substance abuse and health disparities. There are currently over 25 extramural grant applications in the pipeline from CORNET awardees.
“For new assistant professors or those who are new to an area of research, the CORNET Awards allow you some breathing room and the ability to explore your research options,” Dr. Stanfill said. “Its collaborative roots force you to explore the intersection of multiple disciplines. The data generated from my CORNET Award was integral in helping me attain this R01 award.”
Dr. Goodman, pleased at the news of Dr. Stanfill’s new award, also nods at the success of the CORNET Awards program in helping UTHSC investigators perform cutting-edge research and discover new areas of interest.
“Dr. Stanfill’s work will lay the foundation for a long-term program of research in her lab, the development of targeted interventions designed to reduce post-stroke disability and improve quality of life for all subarachnoid hemorrhage patients,” Dr. Goodman said. “The Office of Research has invested over $1.4 million into the CORNET Awards program, with a return on investment of over $5.4 million. The positive response is overwhelming and it brings me great pleasure to know that this program continues to successfully propel our researchers forward.”
Her project titled, “A Multivariate Predictive Model for Long-term Disability Post Subarachnoid Hemorrhage in Caucasian and African American Populations,” is funded for three years.