RESEARCH SPOTLIGHT: Hamilton Health Sciences

Hamilton researchers discover a simple blood test could save lives after surgery

Researchers at Hamilton Health Sciences’ Population Health Research Institute (PHRI) and McMaster University have determined that a simple blood test can predict and possibly prevent many of the deaths that occur after surgery.

“If death after surgery within the first 30 days was made its own category of death, it would be in the top 5 leading causes of death within North America,” explained Dr. P.J. Devereaux, principal investigator for the “VISION” study.

The VISION study enrolled nearly 22,000 patients aged 45 years or older from 23 hospitals in 13 countries and found that approximately 18 per cent of them sustained heart damage within 30 days of non-cardiac surgery and that, without enhanced monitoring, the vast majority – as many as 93 per cent – of these complications will go undetected, potentially until it’s too late to intervene.

Putting pressure on the heart

“The effects of surgery anywhere in the body create a perfect milieu for damage to heart tissue, including bleeding, blood clot formation, and long periods of inflammation,” says Dr. Devereaux, scientific leader of perioperative medicine at PHRI, director, division of cardiology at McMaster University. “In most cases, this damage occurs within the first 24 to 36 hours after surgery when patients usually receive narcotic painkillers that can mask symptoms of cardiac distress.”

“These discoveries have the potential to save lives.”

After surgery, study patients had a blood test for a protein called high-sensitivity troponin T, which is released into the bloodstream when injury to the heart occurs. Devereaux and his team discovered that patients with troponin T levels beyond a certain threshold had increased risk of death within 30 days of having surgery.

Overall, the study found that 1.4 per cent of patients died within 30 days following non-cardiac surgery.

“One per cent seems like a small number, until you consider that about 200 million surgeries are performed each year around the world,” says Devereaux. “Where we’re letting patients down is in post-operative management. We now know that we need to become more involved in care and monitoring after surgery to ensure that patients at risk have the best chance for a good recovery. These discoveries have the potential to save lives.”

The results of the VISION study were published in The Journal of the American Medical Association.

 

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Hamilton Health Sciences is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more Research Spotlight posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.

Health and Community Leaders Talk: David Hill

By David Hill, Scientific Director, Lawson Health Research Institute and Integrated Vice President of Research for London Health Sciences Centre and St. Joseph’s Health Care London

Dr David Hill Lawson Health Research Institute

What does health research mean to you?

Health research means delivering the best health care by pushing the boundaries of science. It’s about understanding the basis of wellness and the dysfunctions of the body and mind that result in disease. At Lawson, our research expands the full continuum of life and mirrors the clinical areas at London Health Sciences Centre and St. Joseph’s Health Care London. We make it our mission to test and deliver health care innovations for the benefit of patients in our community, in Ontario and beyond.

Health research also drives the future of health care—looking not just at where we are now but where we could be in ten or fifteen years. Ontario’s research hospitals bridge the gap between today’s discoveries and the next generation of health service and delivery. Where we could be won’t happen by chance. It will be the result of hospital-based research.

Read more: Behind the scenes at Lawson

How does health research contribute to a healthier, wealthier, smarter Ontario?

Healthier: Health research makes our patients healthier as the discovery of new treatments leads to improved health outcomes and a higher quality of life.  At Lawson, we take a “bedside to bench to bedside” approach. Our researchers focus their efforts on figuring out the clinical problem, and then take that back to the lab to develop new knowledge that can be translated directly to better patient care. At Lawson we built our strategic plan around precisely identified clinical problems and their resolution through inter-disciplinary research.

Wealthier: Health research is good for the economy as our researchers work to discover new ways to drive efficiency and reduce costs; find new methods of service delivery; improve procedures,; and create entirely new ones, like specialized molecular imaging techniques. We’re also commercializing our innovations through WORLDiscoveries®. Born out of a partnership between Lawson, Robarts Research Institute and Western University, WORLDiscoveries® is the business development arm of London’s extensive research network and the bridge between local invention and global industry.

Smarter: Health Research makes our communities smarter by attracting the best and brightest health care professionals. We’re seeing this at Lawson as we continue to grow our reputation as a leader in the life sciences sector, with over 1,500 principal investigators, research support staff, students and trainees. This growth feeds on itself, helping us to attract top talent to our city, like Dr. Chris McIntyre, a nephrology researcher who came to Lawson from the UK in 2014.

At Lawson, one thing we believe in strongly is that investment in health research is good for all of us – in London, across Ontario, and in Canada. In today’s tough funding landscape, we must ensure that health research remains a priority for health system leaders, and leaders in the broader community.

 

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Read more Health and Community Leaders Talk blog posts on our Healthier, Wealthier, Smarter site and share your insights on Twitter with the hashtag, #onHWS. To learn more about how health research makes Ontario healthier, wealthier, and smarter, check out our website and our other blog posts and videos.

Patients + Research: Joan Baillie

Meet Joan

Three years ago, Joan Baillie was diagnosed with Mild Cognitive Impairment (a condition that is likely to develop into dementia). She participated in a brain rehabilitation research study at Baycrest Health Sciences led by Rotman Research Institute senior scientist, Dr. Brian Levine, and learned strategies to improve focus and complete everyday tasks through his Goal Management Training intervention. Since her diagnosis, Joan continues to function well and enjoy life.

Joan Baillie Baycrest Research Toronto

Can you tell us a bit about yourself and your health story?

More than 20 years ago, I had a mini stroke (also known as a Transient Ischemic Attack (TIA), a condition when the brain’s blood flow is temporarily blocked) and made a full recovery. After I left my car running with the keys inside for two hours, I visited my family doctor about memory concerns. My doctor diagnosed me with Mild Cognitive Impairment and while researching the condition, I read that it could lead to dementia.

A year after my diagnosis, I saw an advertisement about a research study taking place at Baycrest. They were looking for people who experienced a mini stroke or TIA and could benefit from cognitive rehabilitation. I was accepted into the study which would help doctors learn more about the brain and the cognitive changes that may occur with a stroke or mini strokes. The hope is that this will help doctors learn how to best treat those with cognitive problems. This research helped me better understand my memory problems and handle changes that are taking place in my brain.

Short-term memory loss always remains a concern and I am very aware of the signs of dementia.

Why does health research matter to you?

The more the doctors know, the more they can do for you. It’s important that doctors have more knowledge because we are an aging population that is living longer.

The brain scans taken at the start of the study showed that I might have experienced many mini strokes which potentially led to my memory loss. With Dr. Brian Levine’s Goal Management Training, I learned many strategies to help with focus and memory and these allow me to live my life more productively.

How does health research contribute to a healthier Ontario?

I believe without health research we would still be contracting polio, dying from diabetes and not living our lives fully due to brain limitations. Every advance in medicine is the result of research. If research can help find a reliable treatment for those suffering from dementia and/or Alzheimer’s, or even help everyone live their lives to the fullest, then it is absolutely necessary for this research to take place.

The knowledge that is gained from health research will contribute to the future care and treatment of patients with similar problems. It will help medical professionals look after their patients in more productive and understanding ways. It will ultimately save the government many dollars as they will better understand what is needed to serve people who live with dementia or similar conditions. We are approaching a crisis stage because hospitals, nursing homes and the general public are struggling to accommodate those who are living with these diseases.

How can patients and families support, improve or empower health research?

The public should understand that it research is necessary if there is going to be any improvement in the care of people in the future. People should make themselves available for research in any area for which they are experiencing issues. It takes some of your time, but the results will benefit so many patients with dementia or Alzheimer’s. When I told people I was involved in a research study, they congratulated me for doing something positive. We can all do that by sharing our experiences and encouraging other people to become involved in research projects.

 

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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Bradt at ebradt@caho-hospitals.com, 416-205-1469, or direct message or tweet at us on Twitter at @CAHOhospitals.

Read more Patients + Research posts and share your own insights on Twitter with the hashtag #onHWS. To learn more about how health research makes Ontario healthier, wealthier and smarter, visit our impact page, and check out our other blog posts and videos.