SREMI Clinician Scientist Profile | Dr. Grewal

Keerat GrewalSREMI scientist and emergency physician, Dr. Keerat Grewal continues to develop a health services research program focusing on patients with cancer and issues surrounding venous thromboembolism and anticoagulation in the emergency department. This past year, Dr. Grewal successfully completed her research fellowship and has obtained academic appointments as a SREMI scientist, an Assistant Professor with the Department of Medicine at the University of Toronto, and an Adjunct Scientist with ICES. Dr. Grewal was also appointed to the executive committee for the Network of Canadian Emergency Researchers (NCER). This leadership opportunity has allowed Dr. Grewal to expand her collaboration network with emergency medicine researchers across Canada.

Dr. Grewal continues to build on research focusing on patients with cancer in the emergency department. She recently published an article in CMAJ Open, which identified that patients with cancer undergoing treatment frequently require care in the emergency department, and that 1 in 4 emergency department visits in this population are for infection-related diagnoses. She also found there was a higher rate of hospital admission of cancer patients compared to the general Ontario population. These findings will be instrumental in laying the foundation for future work and grant submissions. 

Dr. Grewal has developed several collaborations, including one with emergency physician and thrombosis researcher Dr. Kerstin de Wit. Two studies that Drs. Grewal and de Wit are collaborating on will examine the risk of venous thromboembolism (blood clot) in patients discharged from the emergency department. One of these projects, supported by a CanVECTOR Research Start-Up Award, examines patients with an ankle fracture requiring immobilization in the emergency department. Ankle fracture and their respective treatment can increase the risk of developing a blood clot. In Canada, we do not actively prevent blood clots in people with broken ankles, partly because we believe they are rare, and we cannot tell who is at higher risk for developing a blood clot. The preliminary results of this study suggest that venous thromboembolism in these patients is an issue that needs to be recognized at the time of emergency department discharge. Dr. Grewal virtually presented findings from this project at the Thrombosis Canada and CanVECTOR conference, where she won the 3-minute Project Competition for outstanding research.

Dr. Grewal is also working on the iBLEED-ED study, a study examining the risk of intracranial hemorrhage in older patients seen in the emergency department with a head injury and comparing these risks by anticoagulation status. She continues to mentor junior residents, is supervising multiple resident research projects and has published six peer-reviewed manuscripts this year. Her ICES appointment will guarantee streamlined access to ICES data and allow her to accelerate her health services research program, using population-level data to identify gaps in emergency medicine care and propose ways to improve care in emergency departments across Ontario.

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