toh

Anesthesiologist and scientist Dr. Daniel McIsaac is doing research to better understand why some older patients recover quickly after surgery while others do not.

As Canada’s population ages, more older patients are coming to hospital for surgery. But why do some recover quickly and others develop many complications?

When Dr. Daniel McIsaac, an anesthesiologist and scientist at The Ottawa Hospital, is not in the operating room, he studies how hospitals can improve the recovery of these older patients and reduce their risk of complications.

“The first question we often ask when considering a patient for surgery is, ‘How old are they?’” said Dr. McIsaac, also an assistant professor at the University of Ottawa. Generally, the older a patient is, the riskier the surgery. “But age isn’t everything. I’ve seen 85-year-olds have excellent surgical outcomes and 60-year-olds experience terrible complications.”

Dr. McIsaac thinks the answer could be frailty, a physical and mental condition defined by frequent falls, lower cognitive scores and fewer physical reserves. He recently led a study, published in JAMA Surgery, of 200,000 Ontario surgical patients over age 65. His team found that, just three days after an operation, frail patients died at a rate 30 times higher than non-frail patients. These are the kinds of numbers that Dr. McIsaac would like to change.

“I often see older patients and think, ‘If this was my parent or grandparent, would I want them to have this surgery?’” he said. “The answer is often yes, but not always.”

He hopes the team’s research will help hospitals better identify and treat frail patients before, during and after surgery. One thing that could help is making frail patients stronger before surgery. Dr. McIsaac and his team recently received a grant from the International Anesthesia Research Society to test whether home-based exercise training before cancer surgery can improve the outcomes for these patients.

“If we don’t study and understand the impact that frailty has on outcomes after surgery, we can’t properly disclose the likely risks and benefits of a given surgery to our older patients and their families,” said Dr. McIsaac. “We are working to examine frailty from many different perspectives. Researchers are collaborating with specialists in anesthesiology, surgery, orthopedics, urology, nursing, geriatrics and internal medicine, as well as engaging our patients.”

You might also like…