Researcher aims to make surgery safer for frail patients

September 29, 2016

Anesthesiologist and scientist Dr. Daniel McIsaac is doing research to better understand why some older patients recover quickly after surgery while others do not.

As Canada’s population ages, more older patients are coming to hospital for surgery. But why do some recover quickly and others develop many complications?

When Dr. Daniel McIsaac, an anesthesiologist and scientist at The Ottawa Hospital, is not in the operating room, he studies how hospitals can improve the recovery of these older patients and reduce their risk of complications.

“The first question we often ask when considering a patient for surgery is, ‘How old are they?’” said Dr. McIsaac, also an assistant professor at the University of Ottawa. Generally, the older a patient is, the riskier the surgery. “But age isn't everything. I've seen 85-year-olds have excellent surgical outcomes and 60-year-olds experience terrible complications.”

Dr. McIsaac thinks the answer could be frailty, a physical and mental condition defined by frequent falls, lower cognitive scores and fewer physical reserves. He recently led a study, published in JAMA Surgery, of 200,000 Ontario surgical patients over age 65. His team found that, just three days after an operation, frail patients died at a rate 30 times higher than non-frail patients. These are the kinds of numbers that Dr. McIsaac would like to change.

“I often see older patients and think, ‘If this was my parent or grandparent, would I want them to have this surgery?’” he said. “The answer is often yes, but not always.”

He hopes the team’s research will help hospitals better identify and treat frail patients before, during and after surgery. One thing that could help is making frail patients stronger before surgery. Dr. McIsaac and his team recently received a grant from the International Anesthesia Research Society to test whether home-based exercise training before cancer surgery can improve the outcomes for these patients.

“If we don't study and understand the impact that frailty has on outcomes after surgery, we can't properly disclose the likely risks and benefits of a given surgery to our older patients and their families,” said Dr. McIsaac. “We are working to examine frailty from many different perspectives. Researchers are collaborating with specialists in anesthesiology, surgery, orthopedics, urology, nursing, geriatrics and internal medicine, as well as engaging our patients.”

The Ottawa Hospital: Inspired by research. Driven by compassion

The Ottawa Hospital is one of Canada’s largest learning and research hospitals with over 1,100 beds, approximately 12,000 staff and an annual budget of over $1.2 billion. Our focus on research and learning helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital, affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region, but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care. See for more information about research at The Ottawa Hospital.

University of Ottawa

The University of Ottawa is home to over 50,000 students, faculty and staff, who live, work and study in both French and English. Our campus is a crossroads of cultures and ideas, where bold minds come together to inspire game-changing ideas. We are one of Canada’s top 10 research universities—our professors and researchers explore new approaches to today’s challenges. One of a handful of Canadian universities ranked among the top 200 in the world, we attract exceptional thinkers and welcome diverse perspectives from across the globe.

For further information, please contact

Amelia Buchanan
Senior Communication Specialist
Ottawa Hospital Research Institute
Office: 613-798-5555 x 73687
Cell: 613-297-8315


Disease and research area tags: Aging, Frailty, Patient safety, Surgery

Scientific Program tags: Acute Care Research Program