Is Your Student Safe?

teacher-running-with-aedThe beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone including a seemingly healthy child.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40% of all cases, is hypertrophic cardiomyopathy or HCM.

HCM is a genetic heart condition that affects 1: 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.

sca incidenceApproximately 50% of individuals with HCM experience no symptoms, and don’t even know they have the condition, until tragically, sudden cardiac arrest occurs.  In 9:10 cases the outcome is fatal, resulting in unimaginable grief for families and fellow students.  Yet better outcomes can be achieved with early electrical stimulation of the heart – delivered by a small, fully automated, easy to use box.

Given that educational institutions house more than 20% of the American population every day, you’d think they would be fully prepared for this eventually. But sadly, they are not.

At the time of writing, only 19: 50 states in the U.S. require that at least some of their schools have automated external defibrillators [AED’s].  In some states, AEDs are required in public, but not private schools. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. Only two states – Hawaii and Oregon – require AEDs in colleges.

To find out whether your state requires AEDs in schools, click here to view an interactive map.

Chain of Survival full sizeAlthough schools and colleges are ideal and obvious locations for AED deployment, concerns regarding legal liability and litigation have been perceived as a barrier to purchasing and deploying AEDs.  Fortunately this is slowly changing.  Recognition of the need to protect youth from sudden cardiac arrest is gaining momentum in many states:

In Pennsylvania, Sen. Andrew Dinniman has sponsored Senate Bill 606, Aidan’s Law, named for Aidan Silva, a seven-year-old Chester County resident who succumbed to SCA in September 2010.  Aidan had no symptoms of a heart condition prior to his death. Aidan’s Law will help ensure that every public school in Pennsylvania has an AED that is up to date and ready to use.

Rep. Connie Pillich, of Cincinnati, has introduced a bill focused on SCA in student athletes. House Bill 180 requires the Ohio Department of Health and the Ohio Department of Education to jointly develop guidelines and materials to educate students, parents and coaches about SCA. The measure bans a student from participating in a school-sponsored athletic activity until the student submits a signed form acknowledging receipt of the guidelines and materials created by the health and education departments. Individuals would not be allowed to coach a school-sponsored athletic activity unless the individual has completed, within the previous year, a sudden cardiac arrest training course approved by the health department.

John Ellsessar, whose son Michael died during an Oxford High School football game in 2010 from cardiac arrest, believes automated external defibrillators should be as readily available at school settings as fire extinguishers.

Ellsessar, is pushing for legislation to require all schools to have defibrillators, said he and his wife were horrified when they learned that at most schools that have the medical devices, but they are locked away in nurses’ offices, instead of being ready for emergencies.

CPR-AED-lgAnd in Rhode Island, high school seniors will be required to be trained in CPR and the use of a defibrillator before they can graduate. Under the legislation signed into law by Gov. Lincoln Chafee, students will receive training that includes a hands-on course in cardiopulmonary resuscitation and an overview of the use of an AED.

The National Parent Teacher Association has also adopted a resolution calling for public schools to develop emergency response plans that include summoning help, performing CPR and using automated external defibrillators to save lives. The PTA also called for ongoing CPR-AED training in schools and legislation that would fund placement of AEDs in every school, while providing immunity for people who use the lifesaving devices in good faith.

To learn more about sudden cardiac arrest and how you can help please visit http://www.sca-aware.org

SRxA-logo for web

The Jaws of Life!

national dog dayIn case you missed it, Monday was National Dog Day – also known as: International Dog Day & National Dog Appreciation Day.

National Dog Day serves to help galvanize the public to recognize the number of dogs that need to be rescued each year, and acknowledges family dogs and dogs that work selflessly each day to save lives, keep us safe and bring comfort. Dogs put their lives on the line every day – for their law enforcement partner, for their blind companion, for a child who is disabled, for our freedom and safety by detecting bombs and drugs and pulling victims of tragedy from wreckage.
Founded in 2004 by pet lifestyle expert and author Colleen Paige, National Dog Day was created to honor dogs more than we currently do, to give them “a day”, to show deep appreciation for our long connection to each other – for their endearing patience, unquestioning loyalty, for their work, their capacity for love and their ability to impact our lives in the most miraculous ways.

National Dog Day wishes to encourage dog ownership of all breeds, mixed and pure – and embraces the opportunity for all dogs to live a happy, safe and ”abuse-free life”.

As our regular readers know, we’re big dog lovers here at SRxA’s Word on Health, so it seemed fitting to bring you a happy and healthy tale (or perhaps that should be waggy tail) for the weekend.

dogs and house firesEach year, in the U.S., thousands of people lose their lives to fire.  Unfortunately, we have become accustomed to hearing about these tragedies, but there is another tragedy that occurs in which we rarely hear about – the hundreds of thousands of cherished family pets who suffer injury or death due to smoke and flames.

Government statistics estimate that there are around 400,000 home fires are reported annually. And 62% of these homes will own at least one pet -meaning some 300,000 animals are at risk of smoke inhalation.

Although firefighters and their heroic efforts attempt to save a pet’s life during a burning building, the damage a pet sustains from inhalation of smoke or carbon monoxide overwhelms many of the animals that often die en route to a veterinarian.   But if fire and rescue crews are able to provide life-saving oxygen for animals, as they do for humans, more animals would be saved.

Of the 30,000 or so fire departments in the US, only 1,700 have some type of pet oxygen delivery device.  In Word on Health’s home state of Virginia, there are 24 fire departments with such equipment, including Fairfax, Arlington, Sterling, Chesterfield, Spotsylvania, and Stafford.

Previously, in Prince William County, Lake Jackson Volunteer Fire and Rescue Department was the sole company, within the fire and rescue system, that provided this device.  But now, thanks to a generous donation provided by Prince William SPCA (Society for the Prevention of Cruelty to Animals), firefighters have an opportunity to assist pets who are experiencing respiratory distress or failure due to a fire and potentially save more lives.

WAGN_FirstResponder_Banner_v2PWSPCA purchased 42 of the WAG’N 02 FUR LIFE delivery system/devices –each worth approximately $3,000 and has provided 2 kits to each of the 21 fire and rescue stations in the county.

I was honored and privileged to be asked to coordinate the introduction of the pet oxygen kits at Nokesville Volunteer Fire and Rescue Department and to ensure that all fire and EMS personnel are trained in the use and maintenance of the devices – a process we fittingly began on National Dog Day and hope to have fully operational by the Labor Day holiday weekend.

Dog-with-Oxygen-MaskThe pet oxygen delivery devices work similar to equipment manufactured for humans suffering from smoke inhalation except this device is used solely for four-legged animals.  The device has a cone shaped design with a rubber seal that creates a snug fit over the animal’s nose and mouth making the oxygen delivery more effective than oxygen masks designed for humans.

And while we hope that we never have to use them, we are confident  that by carrying the pet O2 kits on our fire trucks and ambulances that we can minimize the number of animal fatalities that occur due to fire.

What better way to mark dog appreciation day?

SRxA-logo for web

The Sobering Buzz on School Buses

School_BusAs the summer draws to a close and the new school years approaches, now’s the time for parents to sit down with their kids and have “the talk”.

No, not that one!  We’re talking about school bus safety.  According to the National Highway Traffic and Safety Administration, an average of 19 kids die each year as a result of school bus related accidents.

To help reduce this terrible statistic, Susan Laurence, injury prevention coordinator, at Cincinnati Children’s Hospital believes such a talk will help ensure a safe, enjoyable start to the school year for everyone. According to Laurence, many injuries happen when children are boarding or exiting the bus. “A blind spot extends about ten feet in front of the bus, obstructing the driver’s view. Often times, children are not aware of this blind spot and might mistakenly believe that if they can see the bus, the bus driver can see them.”

Laurence offers the following suggestions to parents on how they can ensure their child is safe before, during and after their school bus ride.

school bus safetyWhile Waiting for the Bus 

  • arrive at the bus stop at least five minutes before the bus arrives
  • avoid horseplay while waiting for the bus
  • do not go into the street while waiting for the bus

During the Bus Ride

  • remove loose drawstrings or ties from the child’s jacket and sweatshirt because they can snag on bus handrails
  • when boarding or leaving the bus, children should always walk in a single file line and use the handrail to avoid falls.
  • while on the bus, the child needs to remain seated, forward facing at all times and keep the aisle clear of his feet and his backpack
  • do not shout while on the bus or distract the driver unnecessarily
  • keep head and arms inside the bus at all times

School Bus AccidentAfter the Bus Ride

  • wait for a signal from the bus driver before crossing the street
  • look left, right, left before stepping into the street to make sure there are no cars passing the bus
  • cross the street at least 10 feet (or 5 giant steps) in front of the bus
  • wait until the bus comes to a complete stop before exiting
  • exit from the front of the bus
  • ask the bus driver for help if anything is dropped while entering or exiting the bus
  • do not talk to strangers when walking to and from bus stop

Simple, sensible advice for all parents. Let’s make sure we keep the wheels on the bus this school year and prevent children from ending up under them.

SRxA-logo for web

NSAID’s in the News (again)

Medication - Over the Counter - otcLet me start by saying, that despite spending the last 20-something years in or around the pharmaceutical industry, I don’t like taking pills. That said, I’m not particularly partial to pain either. So when my knees or back hurts or I’m doubled over with dysmenorrhea, like many other people, I’ll reach for the ibuprofen.

But that may be about to change. Results from a new, large international study of non-steroidal anti-inflammatory drugs (NSAIDs), showed that high doses of them increase the risk of a major vascular event such as heart attack, stroke or death from cardiovascular disease by around a third.

In other words, for every 1,000 people with an average risk of heart disease who take high-dose ibuprofen for a year, about three extra would have an avoidable heart attack, of which one would be fatal, the researchers said.

vioxxThis puts the heart risks of generic NSAIDs on a par with Vioxx – the painkiller that U.S. drugmaker Merck famously pulled from sale in 2004 because of links to heart risks.

The study team from Oxford University in the UK, gathered data, including on admissions to hospital, for cardiovascular or gastrointestinal disease, from all randomized trials that have previously tested NSAIDs.

This allowed them to pool results from 639 trials involving more than 300,000 people and re-analyze the data to establish the risks of NSAIDs in certain types of patients.

In contrast to the findings on ibuprofen and diclofenac, the study found that high doses of naproxen, another NSAID, did not appear to increase the risk of heart attacks. The researchers said this may be because naproxen also has protective effects that balance out any extra heart risks.

Researcher, Colin Baigent stressed that the risks are mainly relevant to people who suffer chronic pain, such as patients with arthritis who need to take high doses of for long periods. “A short course of lower dose tablets purchased without a prescription, for example, for a muscle sprain, is not likely to be hazardous,” he said.

He also warns patients not to make hasty decisions or change their treatment without consulting a doctor.

For many arthritis patients, NSAIDs reduce joint pain and swelling effectively and help them to enjoy a reasonable quality of life,” he said. “We really must be careful about the way we present the risks of these drugs. They do have risks, but they also have benefits, and patients should be presented with all those bits of information and allowed to make choices for themselves.”

Donald Singer, a professor of clinical pharmacology and therapeutics at Warwick University, who was not involved in the study, said its findings “underscore a key point for patients and prescribers: powerful drugs may have serious harmful effects.

In the meantime, I for one, will be revising my pain versus pill-popping habit, or switching to naproxen.

SRxA-logo for web

Should You Stay or Should You Go?

family presence during resuscitation2Picture this familiar scene. A critically injured person is wheeled into the emergency room by paramedics. Concerned, shocked and occasionally hysterical family members rush to the patient’s side. An army of doctors, nurses and techs begin emergency resuscitation efforts, inserting breathing tubes, CPR, starting IV’s, drawing blood, administering drugs and other fluids.  One of these health care professionals, nodding toward the family and screaming “Get them out of here!”

We’ve all see it… either in real life or on TV.

Cutting to the next scene, the family is escorted into a stark family crisis room. While healthcare staff work desperately to resuscitate the patient, a social worker updates the family on their progress. If the patient dies, staff  make him as presentable as possible, and then invite the family in to say good-byes. The social worker supports the family during this difficult time, and the code team return to their care of other patients.

For decades, this approach seemed to work well. The common wisdom was that if we did let the family in during the code, they’d either get in the way or become so distraught that we’d have more patients on our hands. Furthermore, we felt we were doing the family a greater service by letting them see their loved one only after we’d removed tubes and lines, even though the calm scene we produced was in total contradiction to actual events.

But recently, this traditional approach has been questioned. It turns out that many family members want to be present during resuscitation efforts, rather than hidden away in a side room.

family presence during resuscitationAnd even though health care professionals are still divided on whether families should be present, most agree the issue must be addressed.

Now, research is starting to question whether family members be allowed to remain in the room as these potentially lifesaving efforts begin?

A two-year study led by a researcher Jane Leske PhD, has shown that family members – parents, spouses, fiancées and adult children – of trauma patients, can benefit by being present during critical moments of care.

Those who do choose to do it really want to be there,” says Leske, professor of nursing at the University of Wisconsin-Milwaukee. “They want to watch everything and get information. It lowers their anxiety and stress to see that everything possible is being done. Seeing is believing.”

However, family presence during resuscitation is controversial and underutilized. Indeed, many health care professionals and hospitals argue against it, concerned that the procedures may be too traumatic for family witnesses, or that family members may become emotionally out of control and interfere with care.

Leske conducted this study in collaboration with medical staff at a facility where families have the option of staying and observing resuscitation efforts. It compared outcomes for family members of patients, ages 18-93, with critical injuries from gunshot wounds or motor vehicle accidents at a Southeast Wisconsin Level 1 trauma center.  The center had offered family presence during resuscitation for more than two years by the time Leske’s study began.

cpr_pr.299225225_stdThe study focused on 140 family members over age 18, divided in two roughly equal groups – those who opted to remain with the victim during resuscitation; and those who chose not to, or were not able to reach the emergency department in time. Researchers interviewed family members within 72 hours after admission to the surgical intensive care unit, to discuss the family’s coping resources, communication and anxiety levels.

She and her research team found a number of benefits to having family members present, and no drawbacks.

They concluded that while families can benefit from being present during resuscitation, it’s also important that the hospital have policies and procedures in place on when and how to allow the option. For example, family presence during resuscitation should not be permitted when family members are intoxicated, extremely agitated or emotionally unstable.

Other researchers agree. A large French study published last month in the New England Journal of Medicine concluded that relatives who did not witness CPR had post-traumatic stress disorder (PTSD)–related symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medico-legal claims.

What are your thoughts on this?  Would you want to stay…or walk away.  Let us know.

SRxA-logo for web

When’s Your Time to Die?

risk of dyingWhat are your chances of dying in the next 10 years?

Obviously there are some activities that may increase your risk  such as driving drunk and active military duty in a war zone, but how about getting winded after walking several blocks or having trouble pushing a chair across the room

Turns out the latter might be just as dangerous as the former.

Researchers at the University of San Francisco VA Medical Center have recently come up with a “mortality index” to predict when a person may die.  Marisa Cruz and her colleagues have developed a list of 12 questions that can help predict chances of dying within 10 years for patients aged 50 and older.  The researchers created the index by analyzing data on almost 20,000 Americans over 50 who took part in a national health survey in 1998. They tracked the participants for 10 years. Nearly 6,000 participants died during that time.

risk of dying 2While the test scores may satisfy people’s morbid curiosity, the researchers say their index wasn’t meant as guidance about how to alter your lifestyle.  Instead, it is mostly for use by doctors, to help them discuss the pros and cons of costly health screenings or medical procedures in patients who are unlikely to live 10 more years.

That said, we know that many of our readers are “simply dying” to take the test themselves – right now.

So without further ado…here’s how it works.

The 12 items on the mortality index are assigned points.  The fewer your total points the better odds of living.

  • Men automatically get 2 points. In addition, men and women ages 60 to 64 get 1 point; ages 70 to 74 get 3 points; and 85 or over get 7 points.
  • Two points each for: a current or previous cancer diagnosis, excluding minor skin cancers; lung disease limiting activity or requiring oxygen; congestive cardiac failure; smoking within the past 2 weeks; difficulty bathing; difficulty managing money because of health or memory problem; difficulty walking several blocks.
  • One point each for: diabetes or high blood sugar; difficulty pushing large objects, such as a heavy chair; being thin or normal weight.


The highest, or worst, score is  26, which equates to  a 95% chance of dying within 10 years. To get that, you’d have to be a man at least 85 years old with all the above conditions.
healthy young womanFor a score of zero, which correlates to a 3% chance of dying within 10 years, you’d have to be a woman of “normal weight” younger than 60 without any of those infirmities.

While it’s hardly surprising that a sick, older person would have a much higher chance of dying than someone younger why would being overweight be less risky than being of normal weight or slim?  One possible reason is that thinness in older age could be a sign of illness.

Dr. Stephan Fihn, a health quality measurement specialist with Veterans Affairs health services in Seattle, said the index seems valid and “methodologically sound.”
However, he adds that it is probably most accurate for the oldest patients, who don’t need a scientific crystal ball to figure out their days are numbered.

For fans of SRxA’s Word on Health, I’m pleased to report that my 10-year mortality index is zero. Let the blogging continue!

SRxA-logo for web

Papal Poor Health

frail Pope On February 11, Pope Benedict XVI stunned the Catholic Church and the world when he announced his resignation by saying he no longer had the mental and physical strength to carry on.

At 8pm local time yesterday, he ended his difficult reign, marking the first time in six centuries a pope has resigned instead of ruling for life.

But what do we really know of his health or that of other popes before him?

The Vatican recently confirmed Benedict had a pacemaker for years, indicating a long-standing heart problem. And his older brother told the press that age had taken its toll.

Other observers have noticed the pope’s reduced energy. The press reported that he was ferried to the altar at St. Peter’s for Midnight Mass Christmas Eve on a wheeled platform and then appeared to doze off during the service.

Pope frailVisiting Mexico last year, he awoke at night and couldn’t locate a light switch in his room, then fell and bloodied his head when he hit the bathroom sink.

Beyond these few facts, we know very little about the health problems that led Benedict to announce his retirement. We don’t even really know if his flagging stamina was the true reason behind his resignation.

And while Pope Benedict XVI might be the first Holy Father to voluntarily resign because of old age and deteriorating health, the papacy has a past medical history of poor health.  According to the history books, these ailments range from depression to gout to cancer.

According to church law, as long as a pope is able to conduct Mass, he can continue in his role even if he is suffering, in pain or even bedridden, as was the case with Pope Alexander VII.

Pope Alexander VII’s surgeon and confessor tried to persuade him not to go before the crowd on Easter Sunday of 1667, but he did it anyway. The pope died three days later, according to author Wendy J. Reardon in The Deaths of the Popes.”

Pope_Clement_XII,_portraitMore than a century later, Pope Clement XIV became known as the pope who drooled and had eyes that “darted in their bulging sockets” as he fearfully clung to walls for fear of a Jesuit assassination attempt. He died after correctly predicting his own death in 1774.

In 1958, Pope Pius XII died after enduring recurring bouts of hiccoughs for five years. At one point, his hiccoughs became so intense, that they tore the lining of his stomach. He died of complications from pneumonia at 82 years old.

Pope John Paul II, was sick until he died on April 2, 2005 at 85 years old. He lived with Parkinson ‘s disease for decades, but he died of cardio-respiratory failure, kidney failure and septic shock.

Death has never been an issue that has worried popes,” says papal historian Anura Guruge,  “Popes talk about no purgatory for popes.” Instead they believe if God is ready for a new pope, he will simply call the current one home to heaven where they will immediately be admitted to God’s house and be in the presence of the Holy Father. Not surprising then, that many popes have gone so far as to express enormous amounts of joy on their death beds.

Emeritus Pope Benedict XVI, was one of the oldest popes when he was elected in 2005 at age 78. In 1991 he had a stroke that reportedly temporarily affected his vision. He fell in 1992 and again 2009. He was also thought to have either arthritis or arthrosis, a similarly painful and debilitating joint condition.

Father Virgilio Elizondo, a professor at the University of Notre Dame in Indiana, said he thinks Pope Benedict XVI made a very difficult but wise decision by resigning. He added that the papacy has a history of unpredictability, and the surprise resignation fits right in.

pope John paulI think when you consider the sincerity of the man, when you consider the weight of the universal church, and the greatest variety of issues affecting the church and the rest of the world, I could see how he could come to that decision,” says Elizondo. “What’s really needed is a younger person with more vigor and up-to-date knowledge about what’s happening. I think that’s the rationality behind this pope.

But not everyone agrees.  “This pope’s resigning is essentially overriding God’s will,” said Guruge. “We had suspected that he had more health issues than had been made public. … A pope resigning is really not the right thing to do.”

Pope Benedict XVI was just 73 days away from being the third oldest pope. However, he will remain the fourth oldest pope because his resigned before his 86th birthday. The three older popes were Pope Clement X, who lived to be just over 86 years old; Pope Clement XII, who lived to be 87; and Pope Leo XIII, who before his death at 93 was known as the “eternal pope” because he kept on living! Back then, it might be argued, the job was less demanding because the pope didn’t have to be on television or travel the world or tweet.

SRxA-logo for web

Help for the Holiday Blues

It’s the most wonderful time of the year
With the kids jingle belling
And everyone telling you “Be of good cheer”
It’s the most wonderful time of the year
It’s the hap-happiest season of all
With those holiday greetings and gay happy meetings
When friends come to call
It’s the hap- happiest season of all

For many this truly is the happiest and most wonderful time of the year. But for those who have lost a loved one, the empty chair at the table or fewer presents under the tree can be a painful reminder of our loved ones who are no longer with us.

There are so many traditions associated with the holiday season that it can be an emotional roller coaster for someone who has recently lost a loved one,” says Nancy Kiel, bereavement coordinator for Loyola University Health System. “Many people wish they could just fast forward through the holidays, but getting through the season is possible if you give yourself permission to be flexible.”

So for all those who are grieving and mourning the loss of someone this Holiday season here’s some tips that might help make the holidays a little brighter.

  1. Discuss holiday plans as a family. Everyone is feeling the loss, so talk about what you are going to do and be willing to compromise. If you don’t like the change you made, next year you can always go back to the way you did it before.
  2. Skip the mall. Christmas shopping can be stressful even when not dealing with grief. Consider giving gift cards or shop online to avoid the mall madness. Remember it’s not just about the presents, but about the presence of caring and supportive people.
  3. You can say no. The party invitations and social gatherings might be more difficult this year. You can say no or give yourself some breathing room by asking to RSVP at a later date. If you do go, drive yourself. This will allow you the freedom to leave at your discretion. Also, try to avoid “should people” who say “you should do this or you should do that.”
  4. Honor your loved one. Start a new tradition to honor and remember your loved one. You could light a special candle, at dinner have everyone at the table share a favorite memory or all take part in a loved one’s favorite holiday activity. Do something that would make your loved one smile.
  5. Be gentle with yourself. Do what you need to do and pamper yourself. If you need to take a nap, take a nap. Exercise is a great stress reliever, so bundle up and take a walk.
  6. It’s OK to change traditions. Do something different this year. Take a vacation somewhere hot. Skip the cooking and go to a restaurant, volunteer with those even less fortunate.

“Grief is hard work and it can be exhausting, but it is something we must do,”  advises Kiel. “If you put it on a back burner you’ll never heal. You can’t go around, over or under grief – you have to go through it. So find someone who will listen unconditionally and tell your story.”

For more information, visit www.loyolamedicine.org or call Nancy Kiel at (708) 216-1646.

The Ultimate Life Test?

Imagine a simple blood test that could tell you if you’re going to die. Would that be super cool or super scary?  Well, imagine no more, it turns out there is such a test.

Researchers at McMaster University have found a test that can identify people who are at high risk of dying in the month after surgery.  Apparently elevated levels of troponin T (a protein marker of heart injury) correlate with an increased risk of death.

Currently, troponin levels are not commonly measured after most types of surgery.

The results from the Vascular Events In Non-cardiac Surgery Patients Cohort Evaluation (VISION) study, the largest international prospective study evaluating complications after surgery, have just been published in the Journal of the American Medical Association (JAMA).

VISION enrolled 15,133 adult patients in North and South America, Asia, Australia, and Europe.  Troponin T was measured daily during the first three days after surgery. Patients were followed while in the hospital and at 30 days after surgery.

VISION demonstrated that a simple blood test strongly identifies which non-cardiac surgery patients are at high risk of dying in the next 30 days,” said Dr. P.J. Devereaux, VISION principal investigator.

According to Devereaux the results also demonstrated that most patients did not die until an average of six or more days after their troponin T blood test was identified as elevated. “This holds out great hope that there is time to intervene.”

Knowing who is at risk through the test can help physicians target patients who need enhanced observation or interventions.

Surgery activates pathways of inflammation, stress, and clotting that predispose the heart to injury. As a result, many patients suffer heart attacks after surgery. The majority of these patients, however, will not experience chest pain. Evidence from this study supports experts who have advocated the use of troponin blood tests after surgery.

The VISION study suggests that myocardial injury detected through elevated troponin T may explain 42% of deaths that occur after surgery.

This study has substantial potential to change how patients are monitored after surgery,” said Dr. Jean Rouleau, scientific director of the Institute for Circulatory and Respiratory Health of the Canadian Institutes of Health Research. “These results hold substantial promise that through measuring troponin blood tests after surgery, physicians can identify which patients are at high-risk of dying and this can allow them to consider enhanced monitoring and interventions in an attempt to improve outcomes. This is a good example of how a carefully conducted clinical study can impact  patient care.”

SRxA’s Word on Health would like to know if you would take the test.