Recently, three University of Wisconsin Department of Surgery faculty received research grants from the National Institutes of Health. Each will move surgery forward in their individual specialties; read on to learn more about their projects.
Margaret “Gretchen” Schwarze, MD, MPP: Scenario Planning for Older Adults
Dr. Gretchen Schwarze of our Division of Vascular Surgery received a five-year, $3.6 million research grant from the National Institute on Aging. Her study will focus on improving communication between healthcare providers, older adult patients and their families when treating the patient for a severe traumatic injury.
While treatment options for traumatic injuries may include surgery and a hospital stay in the intensive care unit (ICU), many older adults facing end-of-life care may prefer to avoid either scenario. Dr. Schwarze and her research team previously developed Best Case/Worst Case ICU, one of many tools in Dr. Schwarze’s ongoing research project The Patient Preferences Project, which uses scenario planning and graphical tools to help clinicians better communicate with patients and their families. This newly funded study will compare the effectiveness of the Best-Case/Worst-Case-ICU tool with standard-of-care approaches at eight trauma centers across the US, and the outcomes for 4,500 older adult (age 50+) patients in admitted to the ICU, evaluate for three or more days due to a serious injury.
Dr. Schwarze and her team will assess the quality of communication from the perspective of the family, clinicians’ moral distress and burnout, and the patient’s length of stay in the ICU. Ultimately, the results of this study may improve the care older adults receive in the trauma ICU by changing the way clinicians communicate with patients and their families about treatment and prognosis, and to ensure that the treatments patients receive are consistent with their general health goals.
Angela Ingraham, MD, MS: Rethinking Patient Transfer Intervention
Dr. Angela Ingraham in our Division of Acute Care and Regional General Surgery received a two-year, $311,000 research grant from the National Institute on Aging under their Grants for Early Medical/Surgical Specialists’ Transition to Aging Research (GEMSSTAR) program. Her study will focus on improving communication when transferring older adult (age 65+) patients between hospitals for non-trauma related surgical diagnoses.
Older adult patients tend to face worse outcomes for many reasons, one of which may be poor communication between the referring hospital and the receiving hospital. Dr. Ingraham’s research will adapt and test an existing patient transfer intervention with the goal of improving outcomes for older adult patients who are transferred to a new hospital to receive care for common emergency surgery diagnoses.
To do this, Dr. Ingraham works with numerous staff at both referring and receiving hospitals, who will provide input on how best to modify the existing patient transfer intervention in a general emergency surgery setting. With this data, Dr. Ingraham will create a standardized toolkit that will be piloted at UW Health for one year, evaluating both how the toolkit is used along with outcomes in 100 older adult patients who fall under the toolkit’s parameters. The results of this pilot study will be used to refine the intervention and toolkit as needed and will inform a larger study to test the intervention at additional hospitals.
Matthew Brown, PhD: Cell-based heart attack therapy
Dr. Matthew Brown in our Division of Transplantation was awarded a one-year, $382,000 research grant from the National Heart, Lung, and Blood Institute. Dr. Brown’s laboratory focuses on the development and testing of cell-based therapies that can improve patient outcomes after organ transplantation by preventing rejection of the transplanted organ.
Pluripotent stem cells (PSCs) are a promising type of cell that has the ability to divide and develop into any of the different types of cells in our body, including cells that make up our organs and muscles. In theory, PSCs could be gene-edited in a way that would allow the cells to be recognized as “self” by the patient’s immune system, preventing the immune system from rejecting a PSC therapy and the need for life-long medication that suppression reduces the immune system.
Dr. Brown’s newly funded study will focus on PSC-based treatments for heart attacks. Heart attacks cause cells in the heart muscle to die, and PSC-based therapies can make new heart cells grow to reduce the damage. Dr. Brown’s lab will use gene editing to develop a new PSC-based therapy for heart attacks that does not activate the immune system, and will test this therapy in special “humanized” mice that receive these transplanted cells. The results of this study will support future studies of how PSCs can be modified to prevent the rejection of transplanted cells and organs in critically ill patients.
Congratulations to Drs. Schwarze, Ingraham and Brown about their research grants! We are excited to see what happens next in each of these exciting projects.