scholarly journals Local Public Health Surveillance of Heroin-Related Morbidity and Mortality, Orange County, Florida, 2010-2014

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 80S-87S ◽  
Author(s):  
Toni-Marie L. Hudson ◽  
Benjamin G. Klekamp ◽  
Sarah D. Matthews
Keyword(s):  
Orange County ◽  
The United States ◽  
Data Availability ◽  
Data Sources ◽  
Morbidity And Mortality ◽  
Medical Examiner ◽  
Surveillance Systems ◽  
Time Data ◽  
Mortality And Morbidity ◽  
Ed Visits

Objectives: Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014. Methods: We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics–Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources. Results: Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability. Conclusions: These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near–real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.

Drowning in Infants, Children, and Adolescents

PEDIATRICS ◽  
1993 ◽  
Vol 92 (2) ◽  
pp. 292-294
Author(s):  
Keyword(s):  
Lifetime Cost ◽  
Geographic Location ◽  
The United States ◽  
Cost Of Care ◽  
Childhood Mortality ◽  
Surveillance Systems ◽  
Preventive Strategies ◽  
Injury Death ◽  
Mortality And Morbidity ◽  
Near Drowning

Drowning and near-drowning are major causes of childhood mortality and morbidity from injury. From 1980 to 1985, drowning was the second leading cause of injury death of infants and children younger than 15 years of age in the United States.1 In 18 of the 50 states, drowning was the number one cause of unintentional injury death of children 1 to 4 years of age.1 Children less than 5 years of age and young people aged 15 to 24 years have the highest drowning rates.2 Drowning, by definition, is fatal; near-drowning is sometimes fatal. Drowning has been defined as a death resulting from suffocation within 24 hours of submersion in water; victims of near-drowning survive for at least 24 hours.3 For every child who drowns, four children are hospitalized for near-drowning.4 One third of those who are comatose on admission but survive suffer significant neurologic impairment.4 The annual lifetime cost attributable to drowning and near-drowning in children less than 15 years of age is $384 million.3 The annual cost of care per year in a chronic care facifity for an impaired survivor of a near-drowning event is approximately $100 000.4 There is no national surveillance system that defines the circumstances surrounding a drowning event well enough to enable the development of effective preventive strategies for children. A need exists to establish uniform state or local surveillance systems that consider developmental age groupings and geographic location and that account for environmental and behavioral factors that place children at risk. To design preventive strategies aimed at specific risk factors, such surveillance systems must define in sufficient detail the circumstances under which the drowning event occurred, preventive measures used, rescue efforts made, and the outcomes.

scholarly journals Potential for establishing an injury surveillance system in India: a review of data sources and reporting systems

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jagnoor Jagnoor ◽  
Manickam Ponnaiah ◽  
Matthew Varghese ◽  
Rebecca Ivers ◽  
Rajesh Kumar ◽  
...  
Keyword(s):  
Data Collection ◽  
Surveillance System ◽  
Unintentional Injury ◽  
Injury Surveillance ◽  
Data Sources ◽  
Surveillance Systems ◽  
Unintentional Injuries ◽  
Injury Surveillance System ◽  
Mortality And Morbidity ◽  
Morbidity Data

Abstract Background Unintentional injuries account for 10% of deaths worldwide; the majority due to road traffic injuries, falls, drowning, poisoning and burns. Effective surveillance systems provide evidence for informed injury prevention and treatment and improve recovery outcomes. Our objectives were to review existing sources of unintentional injury data, and quality of the data on the burden, distribution, risk factors and trends of unintentional injuries in India and to describe strengths and limitations of health facility-based data for potential use in injury surveillance systems. Methods We searched national and international organisations’ websites to identify unintentional injury-related mortality and morbidity data sources in India. We reviewed and evaluated data collection methods for surveillance attributes recommended by World Health Organization (WHO). We visited health facilities at all levels from public and private sectors, emergency transport centres, insurance offices and police stations in settings reporting significant number of injuries. In these sites, we interviewed key stakeholders using an explorative approach on current data collection processes and challenges to establishing an injury surveillance system based on WHO guidelines. Results Major gaps were highlighted in injury mortality and morbidity data in India, including ill-defined causes of injury deaths and lack of standardisation in classification and coding. Site visits revealed that reporting standards of injuries varied, with issues around clarity of definitions, accountability, time points and lack of reporter/coder training. Major challenges were lack of dedicated staff and training. Conclusions There is an important need to build human resource capacity, integrate data sources, standardise and streamline data collected, ensure accountability and capitalise on digital health information systems including insurance databases.

scholarly journals Fragile X Syndrome-Associated Emergency Department Visits in the United States, 2006–2011

2020 ◽  
Vol 125 (2) ◽  
pp. 103-108
Author(s):  
Thuy Quynh N. Do ◽  
Catharine Riley ◽  
Pangaja Paramsothy ◽  
Lijing Ouyang ◽  
Julie Bolen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Fragile X Syndrome ◽  
Fragile X ◽  
The United States ◽  
Emergency Department Visits ◽  
Surveillance Systems ◽  
Diagnosis Code ◽  
National Data ◽  
Ed Visits

Abstract Using national data, we examined emergency department (ED) encounters during 2006–2011 for which a diagnosis code for fragile X syndrome (FXS) was present (n = 7,217). Almost half of ED visits coded for FXS resulted in hospitalization, which is much higher than for ED visits not coded for FXS. ED visits among females coded for FXS were slightly more likely to result in hospitalization. These findings underscore the importance of surveillance systems that could accurately identify individuals with FXS, track healthcare utilization and co-occurring conditions, and monitor quality of care in order to improve care and reduce FXS-associated morbidity.

scholarly journals Wikipedia: a tool to monitor seasonal diseases trends?

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Pascal Vilain ◽  
Sophie Larrieu ◽  
Sébastien Cossin ◽  
Céline Caserio-Schönemann ◽  
Laurent Filleul
Keyword(s):  
Web Applications ◽  
The United States ◽  
Surveillance Systems ◽  
Influenza Like Illness ◽  
Times Series ◽  
Related Information ◽  
Health Related ◽  
Ed Visits ◽  
Data Source

ObjectiveTo explore the interest of Wikipedia as a data source to monitorseasonal diseases trends in metropolitan France.IntroductionToday, Internet, especially Wikipedia, is an important part ofeveryday life. People can notably use this popular free onlineencyclopedia to search health-related information. Recent studiesshowed that Wikipedia data can be used to monitor and to forecastinfluenza-like illnesses in near real time in the United States [1,2].We carried out a study to explore whether French Wikipedia dataallow to monitor the trends of five seasonal diseases in metropolitanFrance: influenza-like illness, gastroenteritis, bronchiolitis,chickenpox and asthma.MethodsTo collect Wikipedia data, we used two free web applications(https://stats.grok.se and https://tools.wmflabs.org/pageviews), whichaggregate daily views for each French entry of the encyclopedia.As some articles have several entries (redirects), we collectedview statistics for all the article entries and added them to make timeseries from January 1st, 2009 to June 30, 2016 (Figure 1). Then, wecompared these data to those of OSCOUR®network, which is a robustnational surveillance system based on the emergency departments.For each disease, we modelized daily variations in Wikipedia viewsaccording to daily visits in ED using Poisson regression modelsallowing for overdispersion. The following adjustment variables wereincluded in the model: long-term trend, seasonality, day of the week.We tested several lags (day-7 to day+7) in order to explore whetherone of the two indicators (Wikipedia view or ED visits) varied earlierthan the other.ResultsThe mean number of daily views was 764 [16-8271] for influenza-like illness, 202 [6-1660] for bronchiolitis, 1228 [59-10030] forgastroenteritis, 475 [21-2729] for asthma and 879 [25-4081] forchickenpox. Times series analyses showed a positive associationbetween page views and ED visits for each seasonal disease (Figure 2).For each increase in 100 Wikipedia views, the number of ED visitsthe same day increased by 2.9% (95% CI=[2.5-3.3]) for influenza,1.8 (95% CI=[1.4-2.2]) for bronchiolitis, 2.4% (95% CI=[2.2-2.7])for gastroenteritis, 1.4% (95% CI=[1.0-1.7]) for asthma and 2.9%(95% CI=[1.7-4.1]) for chickenpox. Globally, the highest relativerisks were observed for lag-1 (day-1) to lag0.ConclusionsThis study allowed to show that French Wikipedia data canbe useful to monitor the trends of seasonal diseases. Indeed, theywere significantly associated with data from a robust surveillancesystem, with a maximum lag of one day. Wikipedia can thereforebe considered as an interesting complementary data source, notablywhen traditional surveillance systems are not available in real time.Further works will be necessary to elaborate forecasting models forthese seasonal diseases.Figure1. Daily number of page views and ED visits for seasonal dieases,January 1st, 2009 to June 30, 2016Figure2. Relative risk between Wikipedia page views and ED visits forseasonal diseases by several lags

scholarly journals Periprocedural safety of Pipeline therapy for unruptured cerebral aneurysms: Analysis of 279 Patients in a multihospital database

2015 ◽  
Vol 21 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Robert J McDonald ◽  
Jennifer S McDonald ◽  
David F Kallmes ◽  
Giuseppe Lanzino ◽  
Harry J Cloft
Keyword(s):  
Hospital Mortality ◽  
The United States ◽  
Neurological Complications ◽  
Unruptured Aneurysm ◽  
Adverse Outcomes ◽  
Flow Diversion ◽  
Morbidity And Mortality ◽  
Term Care ◽  
Mortality And Morbidity ◽  
Relative Safety

The relative safety of unruptured aneurysm treatment with coiling versus flow diversion therapy is unknown. Most data available on flow diversion reflect highly focused patient groups and very experienced operators. We evaluated a national, multihospital patient database to examine periprocedural morbidity and mortality in patients treated with endovascular flow diversion therapy. The Premier Perspective database was used to identify patients hospitalized between May 2011 and March 2013 for unruptured aneurysm who underwent flow diversion therapy with a Pipeline embolization device. The risk of in-hospital mortality and morbidity was determined using ICD 9 codes. A total of 279 unruptured aneurysm patients at 18 medical centers underwent endovascular therapy with a Pipeline device. Adverse outcomes included in-hospital mortality in two cases (0.7%), discharge to long-term care in 22 cases (7.9%), ischemic complications in 14 cases (5.0%), hemorrhagic complications in four cases (1.4%), and postoperative neurological complications in nine cases (3.2%). This study of a large cohort of patient hospitalizations in the United States provides preliminary data on flow diversion in a “real world” scenario and demonstrates that the periprocedural morbidity and mortality is not negligible and must be considered in the context of the natural history of the aneurysms that are being treated.

Suicidal Behavior and Non-Suicidal Self-Injury in Emergency Departments Underestimated by Administrative Claims Data

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 318-325 ◽  
Author(s):  
Barbara Stanley ◽  
Glenn W. Currier ◽  
Megan Chesin ◽  
Sadia Chaudhury ◽  
Shari Jager-Hyman ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Suicide Attempts ◽  
The United States ◽  
Administrative Claims ◽  
Suicide Attempters ◽  
Self Injury ◽  
Axis I ◽  
Ed Visits ◽  
External Causes ◽  
Severe Psychopathology

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

Big Data Driven Clinical Informatics & Surveillance (BDD_CIS) – A Multimodal Database Focused Clinical, Community, and Multi-Omics Surveillance Plan for COVID-19: A study Protocol (Preprint)

2020 ◽  
Author(s):  
Bankole Olatosi ◽  
Jiajia Zhang ◽  
Sharon Weissman ◽  
Zhenlong Li ◽  
Jianjun Hu ◽  
...  
Keyword(s):  
Big Data ◽  
South Carolina ◽  
Data Science ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Data Sources ◽  
Patient Registries ◽  
Multiple Partner ◽  
Multimodal Data

BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious global pandemic. Currently, all age groups are at risk for infection but the elderly and persons with underlying health conditions are at higher risk of severe complications. In the United States (US), the pandemic curve is rapidly changing with over 6,786,352 cases and 199,024 deaths reported. South Carolina (SC) as of 9/21/2020 reported 138,624 cases and 3,212 deaths across the state. OBJECTIVE The growing availability of COVID-19 data provides a basis for deploying Big Data science to leverage multitudinal and multimodal data sources for incremental learning. Doing this requires the acquisition and collation of multiple data sources at the individual and county level. METHODS The population for the comprehensive database comes from statewide COVID-19 testing surveillance data (March 2020- till present) for all SC COVID-19 patients (N≈140,000). This project will 1) connect multiple partner data sources for prediction and intelligence gathering, 2) build a REDCap database that links de-identified multitudinal and multimodal data sources useful for machine learning and deep learning algorithms to enable further studies. Additional data will include hospital based COVID-19 patient registries, Health Sciences South Carolina (HSSC) data, data from the office of Revenue and Fiscal Affairs (RFA), and Area Health Resource Files (AHRF). RESULTS The project was funded as of June 2020 by the National Institutes for Health. CONCLUSIONS The development of such a linked and integrated database will allow for the identification of important predictors of short- and long-term clinical outcomes for SC COVID-19 patients using data science.

scholarly journals National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

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