Brett Tracy on a Roll: Reuters, AMA Award, EAST Scholarship

December 2019

Brett Tracy checking a patient’s vital signs with Morehouse School of Medicine surgery resident Alex Wang at Grady Memorial Hospital’s Marcus Trauma Center.

Brett Tracy checking a patient's vital signs with Morehouse School of Medicine surgery resident Alex Wang at Grady Memorial Hospital’s Marcus Trauma Center.

The last several weeks of 2019 were a particularly notable period for Emory surgical critical care fellow Brett Tracy, MD, and his research: Reuters Health News circulated his study on metabolic syndrome in severely injured trauma patients beyond standard medical forums, he was the only surgical trainee out of more than 100 presenters to win the Health System Science Resident Award for his abstract at the American Medical Association Research Symposium EXPO in San Diego, and the Eastern Association for the Surgery of Trauma awarded him the John M. Templeton, Jr., MD Injury Prevention Research Scholarship.

The metabolic syndrome study, published by the Journal of the American College of Surgeons, was concerned with how metabolic syndrome, a combination of risk factors including high blood pressure, diabetes, and obesity that has long been linked to an increased risk of cardiovascular complications, may influence outcomes for trauma patients.

"Our data show that metabolic syndrome has a significant impact on mortality and outcomes of trauma patients," Reuters quoted Dr. Tracy as saying. "Not only were there increased rates of cardiovascular (complications) associated with metabolic syndrome, but also significantly longer lengths of hospital and ICU stays, and more time on mechanical ventilation."

The abstract presented by Dr. Tracy at the American Medical Association Research Symposium EXPO, "Community Distress and Social Vulnerability as Predictors of Traumatic Violence and Death," compared the utility of two indices created for other purposes in predicting violent injuries and deaths based on community factors.

The Economic Innovation Group, a bipartisan policy organization, created the Distressed Communities Index (DCI) to evaluate community well-being at the zip code, county, state, and regional level. Meanwhile, the Centers for Disease Control and Prevention created the Social Vulnerability Index (SVI), which measures a community's resilience when confronted by external stresses on human heath, including natural disasters or disease outbreaks. While these indices are not intended to calculate potential of violence, both are comprised of multiple census-collected variables that are intimately related to violence.

Dr. Tracy reported that the DCI and SVI metrics correlated with violent traumas, though DCI was superior to SVI at predicting both violent injury and death. The study team concluded that both indices confirmed that communities with higher rates of unemployment and lower incomes, as well as greater housing vacancy and English language proficiency, were predisposed to violent trauma and death. The team then advised policymakers to use the DCI to identify communities at risk for injury from violence and as a guiding mechanism for interventions and prevention strategies.

The Eastern Association for the Surgery of Trauma's John M. Templeton, Jr., MD Injury Prevention Research Scholarship supports young investigators' performance of interventional trials in the field of injury prevention. In Dr. Tracy's case, the scholarship will assist him in developing an app named SERVE, or Shared Engagement, Recovery and Violence Elimination.

SERVE will be designed to give trauma victims a central source for coordinating all components of their continued treatment, including calendar alerts for appointments; instructions for injury management; and messaging access to providers, managers, and emergency staff.

"There is a real need for technology like this for underserved patients," says Dr. Tracy. "Navigating the health system is challenging enough, let alone if you have minimal resources. This tool could assist in breaking the cycle of violence and incomplete care after discharge."