The research of Sheri Crow, M.D., focuses on evaluating acute illness management strategies while identifying ways in which health care delivery systems, such as the electronic medical record, can be used to conduct high-impact clinical research investigations.
This approach promises to inform clinicians regarding superior management strategies, provide efficient feedback of how practice changes are affecting outcomes, and identify clinical patterns and risk factors that predict poor outcomes.
- Evaluating congenital heart disease perioperative management strategies to improve long-term outcomes. Advances in surgical management for congenital heart disease over the past two decades have resulted in dramatic reductions in operative mortality. However, congenital heart surgery during childhood is often associated with significant morbidity.
Perioperative management strategies have not been rigorously tested and vary greatly across institutions. Current investigations seek to measure the impact of clinical interventions without a clear understanding of the forces at work and the perioperative trends prior to testing that intervention.
In addition, the use of unvalidated endpoints makes the conclusions of these investigations difficult to interpret and apply to clinical practice.
Dr. Crow and a multidisciplinary team that includes cardiac surgeons, intensivists, anesthesiologists, cardiologists and informaticians are approaching these obstacles by describing and defining in detail the period with the highest risk of morbidity and mortality: the acute postoperative period.
Utilizing automated data capture from the electronic medical record combined with existing data from national data collection efforts, clinical trends and perioperative critical periods are being identified.
These critical periods can then be systematically studied to develop clinical trial designs that compare current management strategies and their impact on the perioperative environment and patient outcomes.
- Gastrointestinal bleeding complications in ventricular assist device recipients. Dr. Crow and her team have identified an increased incidence of gastrointestinal bleeding in patients receiving a nonpulsatile flow ventricular assist device.
Patients receiving these devices appear to develop a deficiency in high molecular weight von Willebrand factor multimers. These proteins contribute to clot formation. The combination of high molecular weight multimer deficiency and bleeding is known as acquired von Willebrand syndrome.
Dr. Crow and investigators within the Ventricular Assist Device Program and Division of Hematopathology at Mayo Clinic are working to identify additional factors that may contribute to the bleeding complications observed in some ventricular assist device recipients.
Significance to patient care
Identifying interventions that improve acute postoperative outcomes and translate into reduced postoperative morbidity and mortality promises to improve the quality of life that can be expected for congenital heart disease survivors.
- Chair, Minnesota Congenital Heart Network, 2007-present
- Health Care Delivery Research (HEDER) Scholar, Mayo Clinic, 2012-present