Grant: Operating Grant

Because people are living longer they are now living long enough to develop conditions that require a wide variety of surgeries including, for instance, knee and hip replacement. Worldwide, over 200 million major noncardiac surgeries occur annually, and in Canada 500,000 adults undergo such surgery every year. We, however, do not know how many major vascular complications - such as heart attacks, cardiac arrests, strokes, or death from these causes - occur when patients have surgery, and we do not know the best way to estimate a patient's risk of such complications. Further, we do not know if a simple blood test after surgery will help doctors to avoid missing heart attacks after surgery and predict a patient's risk of death at 1 year after surgery. We will undertake a study to address these issues. Our study will determine: how many patients have a major vascular complication (i.e., heart attack, cardiac arrest, stroke, or death from these causes) within 30 days of surgery; the best method to predict these complications; how many patients have a heart attack after surgery without symptoms; and if these heart attacks affect patient health over the following year. Knowing the current number of major vascular complications after surgery will inform decision makers about the resources required to confront this problem; and knowing the best method to estimate a patient's risk of such a complication around the time of surgery will allow patients and physicians to make informed decisions about the appropriateness of surgery. Finally if a simple blood test after surgery can identify heart attacks that would go unrecognized and predict major vascular events at 1 year this will allow physicians to provide appropriate timely treatments to help these patients survive to enjoy the benefits of their surgery.