The AAST Research and Education Fund is funding three scholarships for 2018-2019. The scholarship recipients will receive their scholarship plaque at the 77th AAST Annual Meeting in San Diego, CA and will present their research findings at the 78th Annual Meeting of AAST & Clinical Congress of Acute Care Surgery in Dallas, TX.
Vanessa Ho, M.D., M.P.H.
Project Title: “Worse than death? Prognosticating Long-Term Recovery Trajectory for Elderly Survivors of Emergency General Surgery.”
We will examine multidimensional factors associated with long-term functional recovery in elderly survivors of emergency general surgery, using a robust longitudinal database of survey and administrative data. Survey questions in the Medicare Current Beneficiary Survey are both broad and deep, and are repeated twelve times over four years, allowing us to follow changes in functional status over time. Our group of multidisciplinary researchers will apply innovative modern statistical methods to study the consequences of pre-existing comorbidities and functional trajectories on postoperative recovery. Our goal for this project is to create a bedside “app” that utilizes both chronic and acute patient function and disease characteristics to prognosticate long-term functional outcomes.
Marta McCrum, M.D., M.P.H.
Project Title: “A Geographic Information System to Evaluate Disparities in Access to Emergency General Surgery”
Emergency General Surgery (EGS) represents an important subset of high-risk surgical admissions in the United States, accounting for nearly 50% of all surgical deaths and $28 billion in costs annually. Timely access and presentation to surgical facilities is critical, as delays in care are associated with increased morbidity and mortality. As in many areas of surgical care, disparities have been identified in access to EGS based on rural location, race, insurance status and socio-economic level. What remains unclear is how spatial access for time-sensitive EGS conditions interacts with these socio-demographic factors to affect clinical outcomes.
The overarching goal of this proposal is to better understand the etiology of disparities in access to EGS. To address this, we will develop a geographic information system (GIS) platform to quantify disparities in access to EGS services for vulnerable populations. By combining clinical data with advanced spatial modeling techniques, we will investigate how geographic access contributes to EGS outcomes and drives these disparities. We anticipate that the development of an EGS-specific GIS platform holds potential to inform future EGS regionalization efforts by identifying conditions in greatest need of triage strategies and ensuring equitable distribution of services for vulnerable patient groups.
Deepika Nehra, M.D.
Project Title: “Understanding the Psychosocial Impact of Traumatic Injury”
Injury remains one of the most common causes of long-term functional impairment and disability. Beyond the physical manifestations of injury, long-term consequences of trauma include psychological disturbances, social disintegration, destruction of families and lack of productivity. Unfortunately, the mental health impact of traumatic injury is, as of yet, poorly understood which stifles our ability to develop meaningful and effective early intervention strategies. We hope to better understand the mental health effects of trauma by first characterizing the burden of mental health conditions after traumatic injury and then determining the risk factors for the development of mental health conditions after trauma. We will also study the effect these mental health conditions have on long-term outcomes. This will be accomplished by phone call interviews conducted at 6 months post-injury. Well-validated screens for post-traumatic stress disorder, depression, anxiety and resilience will be completed in addition to a measurement of physical status and overall functional outcome. This will be followed by a qualitative follow-up survey to identify barriers to seeking care for mental health conditions after traumatic injury. We hope that the results of this work will add much needed insight into the overall mental health burden after traumatic injury thus allowing us to identify those patients at highest risk and provide targeted early intervention strategies.