HAMILTON, ON (December 23, 2019) – A common cardiac blood test done before surgery can predict who will experience adverse outcomes after most types of surgery, says an international study led by Hamilton researchers.
Globally, of the 200 million adults who undergo major surgery, 18 percent will experience serious cardiac and vascular complications including death within 30 days following their intervention, such as hip and knee replacements, bowel resections and abdominal aortic aneurysm repair.
“Any type of surgery has the potential to cause damage to heart tissue, through blood clot formation, long periods of inflammation, or bleeding,” said study lead, Dr. PJ Deveraux, professor of medicine, cardiologist at Hamilton Health Sciences (HHS) and scientific lead for perioperative research at McMaster University and HHS’ Population Health Research Institute (PHRI).
The VISION study looked at whether levels of a cardiac blood test, NT-proBNP, measured before surgery can predict cardiac and vascular complications. Higher levels of NT-proBNP, which can be caused by various anomalies in the cardiac muscle, such as stress, inflammation or overstretch, can help identify which patients are at greatest risk of cardiac complications after surgery.
The study included 10,402 patients aged 45 years or older having non-cardiac surgery with overnight stay from 16 hospitals in nine countries.
“As a result of these findings, doctors can predict who is at greater risk of heart attacks and other negative vascular events after surgery,” said Dr. Devereaux.
This phase of the VISION study builds upon six years of research studies to understand pre- and post-operative factors that lead to cardiac complications.
“This simple blood test can be done quickly and easily as part of patient’s pre-operative evaluation and can help patients better understand their risk of post-operative complications and make informed decisions about their surgery,” said first author of the publication, Dr. Emmanuelle Duceppe, internist and researcher at the Centre Hospitalier de l’Universite de Montreal (CHUM), PhD candidate in clinical epidemiology at McMaster University, and associate researcher at PHRI. “This blood test is twenty times cheaper than more time-consuming tests such as cardiac stress tests and diagnostic imaging.”
Results of this simple blood test may inform the type of surgery the patient will undergo, such as laparoscopic or open surgery, the type of anesthesia used during surgery and who will require more intense monitoring post-operatively.
Blood test results can also reduce the need for pre-surgical medical consultations for patients that show no risk for cardiac complications.
“Heart injury after non-cardiac surgery is emerging as an important health issue requiring attention. Using CIHR funding, the research group led by PHRI and Dr. Devereaux, has clarified the association between an elevation of a common biomarker and the risk of per-operative morbidity and mortality,” said Dr. Brian H. Rowe, Scientific Director, Institute of Circulatory and Respiratory Health, Canadian Institutes for Health Research.
Study data was published today in Annals of Internal Medicine.
Photo caption: PJ Devereaux is a professor of medicine at McMaster University and a cardiologist of Hamilton Health Sciences. Photo courtesy of Hamilton Health Sciences.
For more information or to arrange an interview with Dr. Devereaux, please contact:
905-525-9140, ext. 22169
Hamilton Health Sciences
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Quebec reports 750 new cases of COVID-19, one more death – CTV News Montreal
Quebec health authorities reported 750 more cases of COVID-19 in the province on Monday, bringing the total number of cases since the start of the pandemic to 72,651.
One more death from an unknown date was also recorded in Quebec on Monday, for a total of 5,826.
Monday’s announcement saw an increase of 245 cases on the Island of Montreal (total 33,184) and 125 more in Quebec City (total 3,834). Laval reported an increase of 73 cases (total 7,018) and Monteregie reported 81 (total 10,544). The Eastern Townships reported 28 new cases (total 1,739), the Laurentians, 37 (total 4,703) and Outaouais, 27 (total 1,292). Chaudiere-Appalaches recorded an increase of 41 (total 1,241).
Hospitalizations in the province decreased by four from Sunday to Monday. The number of people receiving treatment for COVID-19 in Quebec hospitals is now 212. Of them, 37 are in intensive care, which is a decrease of four from the number reported on Sunday.
Health Minister Christian Dube called the situation “very worrying” in certain Quebec regions on Monday morning, ahead of a 5:30 p.m. press conference during which he, Premier Francois Legault and public health director Dr. Horacio Arruda are expected to announce that Montreal and Quebec City are entering the ‘red’ zone on the province’s regional alert map. The trio will detail what the red alert level means for Quebecers in those regions.
There are now 61,629 people confirmed recovered from COVID-19 in Quebec, which is an increase of 500 from the number reported on Sunday — or about 84.8 per cent of the total number of cases in the province.
Quebec reported that it completed analyses of 17,310 COVID-19 tests on Sept. 26 (Quebec reports its daily testing figures from two days prior to its daily updates).
The Quebec government has tightened criteria for who can get a COVID-19 test, announcing it will prioritize people who are showing symptoms or who have been in close contact with a positive case.
The provincial health department said in a news release that as cases rise, it’s important to focus on testing those who are most likely to have COVID-19 in order to speed up contact tracing and prevent outbreaks.
Those who don’t fall into either category can be refused testing, the government said.
— with files from The Canadian Press.
Ontario is in a COVID-19 second wave: Ford – Cambridge Times
Of Monday’s cases, 344 were reported in Toronto, 104 cases in Peel Region, 89 in Ottawa and 56 in York Region.
The latest figures prompted Ontario’s hospitals to call on the government to reinstate restrictions in those regions.
The Ontario Hospital Association said the Greater Toronto Area and Ottawa should move back to Stage Two of the province’s pandemic response, which saw restrictions on non-essential businesses like restaurants, gyms, and movie theatres.
Association President Anthony Dale said hospitals could become overwhelmed with patients if such action isn’t taken.
“We can no longer retain a false sense of security and belief that this will not happen to us,” he said in a statement. “At this rate, Ontario hospitals are facing a direct threat to their ability to continue to delivering the highest quality of care to Ontarians.”
The average acute care occupancy rate of Ontario’s hospitals is 89 per cent currently, Dale said, but some of the facilities are already at 100 per cent capacity.
Health Minister Christine Elliott said the province would prefer to not reinstate any Stage Two restrictions but is watching the situation in the GTA and Ottawa closely.
“If we have to tighten up even more we will … because it’s absolutely necessary to protect the health and safety of everyone in Ontario,” she said.
The government said Monday that 128 people are currently hospitalized in Ontario due to COVID-19, including 29 in intensive care.
NDP Leader Andrea Horwath urged the government to make investments needed to get ahead of the second wave.
“We shouldn’t need to slide back into Stage Two,” she said. “But this government is currently doing nothing to prevent that.”
Green party Leader Mike Schreiner asked Ford to outline the metrics that will trigger school closures and a return to Stage Two.
“People need reassurance that the premier is not asleep at the wheel right now, when his actions will determine the severity of the second wave,” he said in a statement.
Meanwhile, Toronto’s medical officer of health said Monday that she is recommending residents limit contact with those they don’t live with.
She said the concept of having 10 people within your social circle, introduced by the province this spring, was sensible at the time but that has now changed since schools and businesses have reopened and case counts are up.
“In Toronto, we have to acknowledge that the extent of infection spread, and the nature of city life, means that the concept of … the social circle no longer reflects the circumstances in which we live,” she said.
De Villa is also recommending changes that would reduce the number of people permitted in bars and restaurants to a maximum of 75 patrons, down from 100. The number of people permitted at a table would also be lowered from 10 to six people.
She is also recommending bars and restaurants collect contact information from every patron and that music be no louder than normal conversation in the establishment.
This report by The Canadian Press was first published Sept. 28, 2020.
By Shawn Jeffords, The Canadian Press
COVID-19 outbreak declared at Lester B. Pearson high school – Newstalk 1010 (iHeartRadio)
A COVID-19 outbreak has been declared at a ninth school in Ottawa.
Officials have declared an outbreak at Lester B. Pearson Catholic High School in Gloucester, with two cases at the school.
There is conflicting information about the nature of the cases. Ottawa Public Health says one student and one staff member tested positive. The Ottawa Catholic School Board is reporting two student cases and zero staff cases.
The board says four classes have been closed as a result of the outbreak.
Ottawa Public Health defines an outbreak in a school as two COVID-19 cases with a proven link between them.
The school is the ninth in Ottawa to have an outbreak since classes resumed. Only one—Monsignor Paul Baxter school in Barrhaven—has been forced to close entirely for at least two weeks.
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