Brett Tracy: Study Selected by Reuters plus AMA Award

November 2019

November was a particularly notable month for Emory surgical critical care fellow Brett Tracy, MD, and his research, with Reuters Health News circulating his study on metabolic syndrome in severely injured trauma patients beyond standard medical forums, and the American Medical Association Research Symposium EXPO in San Diego presenting him with the Health System Science Resident Award.

The study, e-published before print 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."

At the AMA Expo, Dr. Tracy was the only surgical trainee out of more than 100 presenters to win the Health System Science Resident Award for his abstract. "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 also 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. Finally, the team 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.