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.

Patients + Research: Gretta Hutton

Meet Gretta

While parked at the local Home Depot, Gretta Hutton received her diagnosis over the phone: it was Mantle Cell Lymphoma, she had 2 – 5 years to live, and there was no treatment offered beyond the standard of care treatment. After weeks of feeling hopeless, Gretta found a clinical trial at Hamilton Health Sciences led by Dr. Tom Kouroukis. A year later, Gretta’s cancer was in full remission.

Gretta Hutton at CAHO healthier wealthier smarter conference
Gretta shares her insights at the 2015 Healthier, Wealthier, Smarter conference.

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

By day, I am a social worker in the health sector, counselling clients who are struggling with critial illnesses. In 2014, I began to feel ill myself and went to see my doctor for some tests. Driving home from work one evening, I received a call from my internist wanting to share the results. He asked that I pull over so I drove into the parking lot of my local Home Depot where he then gave the diagnosis: stage 4 Mantle Cell Lymphoma. A subsequent meeting with a local oncologist revealed that I had 2 – 5 years to live. More than that, I wasn’t given any alternative treatment beyond the standard of care, RCHOP, that might  help me beat my cancer. But thanks to the persistence of my friend and my sister, I discovered a clinical trial led by Dr. Tom Kouroukis at the Juravinski Cancer Centre at Hamilton Health Sciences (HHS). The care that I am receiving in that trial is outstanding. Dr. Kouroukis listened to me, not just as a patient, but as a person, and walked me through the science of the trial and my care plan.

Why does health research matter to you?

If you asked me two years ago whether I thought I’d be back at work and able to resume my normal activities, I don’t think I would have believed you. This place, and the research here, has saved my life.

I was very ill at the beginning of the research study—sleeping a lot, exhausted—but that started easing up within the first two months. After 12 weeks, I was feeling “normal”. When I didn’t dare to hope that I would beat my cancer, the research team was there, bringing my hope to life with the data and the results from the study. Now here I am, and I have my life back.

Health research, and the clinical trials that result from it, are really important because they offer patients a different path. Having options, especially when you’re ill, is really important.

How does health research contribute to a healthier Ontario?

Clinical trials don’t exist in a vacuum; they are the results of a whole body of scientific study. They move research discoveries into new and better therapies for patients like me. Without health research, you can’t have clinical trials, and without clinical trials, you can’t improve the health of Ontarians.

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

One of the hesitations that people might have in participating in clinical trials is the safety aspect of it. The best people to help reduce fear, hesitation or, in some cases, stigma are the people who have gone through clinical trials. Those of us who have thought through the risks and the benefits, who have worked with the researchers and staff, and who have come out on the other side with renewed hope—we are the ones who need to share our stories with the public and be strong champions for health research.

Patients and the public also have an important opportunity to voice their health research needs to decision makers. If there are life-saving clinical trials and medicines available, then patients should be aware and have access to them. In my role as Ontario Lay Representative on the Canadian Cancer Clinical Trials Network since November 2015, I am working hard to ensure that that conversation takes place at the point of diagnosis for every patient with cancer or other serious illness even if their local hospital is not a research hospital in a major urban centre. Where you live should not be the determining factor in being offered access to research.

Our health system, including research and clinical trials, is a public system, and so the public itself can be a voice of change.

 

 

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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.

 

Building a WEALTHIER Ontario: Hamilton’s Story

As key drivers of Ontario’s knowledge-based economy, research hospitals contribute to a wealthier province by creating innovative, cost-effective products, establishing spin-off companies and partnerships, attracting investment from at home and abroad, and generating high-level jobs.

Across the province, communities are moving towards knowledge-based economies, and Ontario’s research hospitals are helping them get there. To illustrate that transformation, we took a focused look at the city of Hamilton. Traditionally known as Ontario’s steel town, the city has seen significant growth and renewal as a result of its health research sector. And, in the words of Mayor Fred Eisenberger, that growth feeds on itself.

“Once the ball starts rolling, it just doesn’t stop”

In our Wealthier video, Mayor of Hamilton, Fred Eisenberger, explains that the health research sector has led to a spillover effect on the economy—and the community.

The city’s success in health research has led to the growth of its educational institutes. Mohawk is now ranked as one of the top colleges in Ontario with many programs geared towards applied science, and McMaster’s medical school continues to climb on Canada’s top ten list, attracting more and more bright minds. And as Hamilton’s two research hospitals—Hamilton Health Sciences and St. Joseph’s Healthcare—continue to create more high-level jobs, the city is able to retain those bright minds and attract new ones.

Outside the walls of health research, the sector is having a spillover effect on the community, generating a vibrant arts scene, lots of cafes and shops, and more people living and working in revitalized neighbourhoods.

The story of Hamilton offers just one example of the impact that research hospitals are having on communities in Ontario. Thunder Bay, Sudbury, Ottawa, Kingston, Toronto, and London can all speak to similar growth and spillover. In ten years, we can only imagine what that spillover will look like for these communities, and for the province of Ontario.

Quick Facts: Ontario’s Research Hospitals

  • Employ 18,000 researchers and research staff
    • That’s more than twice the number employed at Ontario’s research-based pharmaceutical companies
    • That’s half of the number employed at the assembly plants of Ontario’s big 5 automotive companies
  • Support 41,000 jobs across Ontario
  • Invest $1.4B in health research annually
  • Commercialized 350 new health products in the last four years
  • 14% of research investment comes from private industry
  • Every dollar spent on health research generates three dollars of economic output

 

Discover more about how Ontario’s research hospitals contribute to a wealthier Ontario, and how you can support them, by downloading the Healthier, Wealthier, Smarter Policy Platform.