"In medical school I had a chest surgery and had a horrible recovery -- in the hospital 10 days, and exhausted for about two months," recalled Dan Sessler, MD, professor and chair of the Department of Outcomes Research at the Cleveland Clinic, when I spoke with him recently. "I was so tired I couldn't pick up a remote and turn on the television."
Sessler did recover -- his was a successful surgery -- but going into the operation neither he nor his doctor had any inkling that Sessler wouldn't experience the normal two-week recovery.
Now, research published online in the journal Anesthesiology could lead to an "immune stress test" where blood taken from a patient prior to surgery could help predict when the patients would be back on their feet. The investigators, including co-senior authors/Stanford physicians Garry Nolan, PhD, and Martin Angst, MD, collected blood from 25 hip replacement patients and exposed the blood to chemicals to mimic how the immune system would respond to a traumatic event like surgery. They found the behavior of a white blood cell called a monocyte was related to how quickly patients recovered.
The researchers are working to replicate the findings in a larger study of 80 patients, and they plan to adapt their findings into a test that can run on standard hospital lab machines. As I wrote in our press release about the practical benefits of such a test:
Knowing the likely recuperation times will help patients plan better for their return to work and other post-surgery commitments. For patients at risk for longer recovery times, doctors could schedule additional physical therapy or special care, or the surgery could be postponed while exercise, dietary changes and stress-release techniques are implemented.
As for Sessler, who was not involved in this study, he said he sees great value in adapting the paper's results into a test. Predicting a patient's recovery is "clinically important, and we don't do a good job" of it, he said.
Kim Smuga-Otto is a student in UC Santa Cruz's science communication program and a former writing intern in the medical school's Office of Communication and Public Affairs.
Previously: Discovery may help predict how many days it will take for individual surgery patients to bounce back, New device identifies immune cells at an unprecedented level of detail, inside and out and The importance of human connection as part of the patient experience
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