SOURCES: Brice Gaudilliere, M.D., Ph.D., clinical instructor, Stanford University School of Medicine, Palo Alto, Calif.; Cathy Burnweit, M.D., chief, pediatric surgery, Miami Children's Hospital; Sept. 24, 2014, Science Translational Medicine
WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- Measuring the activity of a type of white blood cell immediately after surgery might reveal which patients are likely to recover quickly and those who won't, a preliminary study suggests.
The study found that a high level of activity in certain white blood cells predicted a poorer recovery for people who'd just had hip replacement surgery.
The researchers plan to test these findings in other operations to see if they can be duplicated. If so, they hope to develop a simple, inexpensive blood test that could guide patients and doctors in predicting recovery and planning medical care after an operation, according to lead researcher Dr. Brice Gaudilliere, a clinical instructor at the Stanford University School of Medicine.
"Surprisingly, there is no way we can tell a patient how long it will take to recover," he said. "Over 100 million patients have surgery in the U.S. and Europe each year. So we are not studying something that is obscure," he added.
For the study, Gaudilliere's team analyzed the recovery of 32 patients who had hip replacement surgery. These patients were picked because they didn't have any other medical conditions that might have affected the results.
Some patients recovered in five to seven days, but for others recovery took a month or more, Gaudilliere said. Recovery was measured by how quickly fatigue and pain decreased and hip function improved.
To see if they could predict patients' recovery, the researchers measured the activity of a special group of white blood cells. These cells have a role in how well the body heals after trauma, Gaudilliere said. They cause inflammation, which initially is a good thing and can help healing, but too much inflammation can impede recovery, according to the study's authors.
The investigators found that when these cells were highly active during the day after surgery, patients took longer to recover than if the activity was low or decreased.
"Their activity level correlated very strongly with how patients recover from surgery. The more active these cells are, the worse the recovery," Gaudilliere said.
"If you are going to have a major surgery, you have to brace yourself for recovery," he explained. "As of now, there isn't much anyone can say. In the future, patients may know how long it will take them to recover," he said.
The report was published Sept. 24 in the journal Science Translational Medicine.
Dr. Cathy Burnweit, chief of pediatric surgery at Miami Children's Hospital, said, "Since there are genetic determinants for virtually every human characteristic, we have to expect that there would be a signature for recovery."
Burnweit believes that knowing the biological basis for recovery might lead to ways to change it and improve recovery after trauma.
This is a very early study in the complexities of the healing process, she said. "This is a first step, but now we can look at the pattern of recovery and alter it to try to make everyone mimic the best recovery," Burnweit suggested.
It is not clear whether the activity of these cells is genetically built into patients' immune systems, or whether their activity is a response to trauma, Gaudilliere said.
According to Gaudilliere, the response to trauma -- whether from an accident or surgery -- is highly structured. If researchers can predict the immune system's response to trauma before it occurs, they might be able to develop a blood test that reliably tells which patients will recover faster and which patients will take longer.
Gaudilliere believes these findings could be used to predict recovery after any trauma, not just surgery.
"We have a study right now in abdominal surgery, and we want to extend this to other types of trauma, like war trauma, maybe traumatic brain injury, and even heart attack and stroke," he said.
For more about recovering after surgery, visit the U.S. National Library of Medicine.