@article{Deyneka_Hakenewerth_Faigen_Ising_Barnett_2017, title={Using Syndromic Surveillance Data to Monitor Endocarditis and Sepsis among Drug Users}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7708}, DOI={10.5210/ojphi.v9i1.7708}, abstractNote={<div style="left: 72px; top: 252.606px; font-size: 11.3333px; font-family: sans-serif; transform: scaleX(1.08137);" data-canvas-width="51.022666666666666">Objective</div><div style="left: 84px; top: 264.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.08589);" data-canvas-width="306.83639999999986">To describe how the state syndromic surveillance system</div><div style="left: 72px; top: 277.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.951453);" data-canvas-width="315.6605333333333">(NC DETECT) was used to initiate near real time surveillance for</div><div style="left: 72px; top: 291.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00201);" data-canvas-width="258.43399999999997">endocarditis, sepsis and skin infection among drug users.</div><div style="left: 72px; top: 316.606px; font-size: 11.3333px; font-family: sans-serif; transform: scaleX(1.11794);" data-canvas-width="66.10733333333333">Introduction</div><div style="left: 84px; top: 328.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00908);" data-canvas-width="303.0272666666666">Recreational drug use is a major problem in the United States and</div><div style="left: 72px; top: 341.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.960925);" data-canvas-width="315.79200000000026">around the world. Specifically, drug abuse results in heavy use of</div><div style="left: 72px; top: 355.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.01717);" data-canvas-width="315.22080000000005">emergency department (ED) services, and is a high financial burden</div><div style="left: 72px; top: 368.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.02797);" data-canvas-width="315.4837333333333">to society and to the hospitals due to chronic ill health and multiple</div><div style="left: 72px; top: 381.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.01925);" data-canvas-width="315.3545333333334">injection drug use complications. Intravenous drug users are at high</div><div style="left: 72px; top: 395.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00223);" data-canvas-width="314.86606666666654">risk of developing sepsis and endocarditis due to the use of a dirty or</div><div style="left: 72px; top: 408.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.01699);" data-canvas-width="315.2332666666667">infected needle that is either shared with someone else or re-used. It</div><div style="left: 72px; top: 421.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.02917);" data-canvas-width="315.5086666666666">can also occur when a drug user repeatedly injects into an inflamed</div><div style="left: 72px; top: 435.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.993887);" data-canvas-width="314.6813333333334">and infected site or due to the poor overall health of an injection drug</div><div style="left: 72px; top: 448.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.999017);" data-canvas-width="314.6904">user. The average cost of hospitalization for aortic valve replacement</div><div style="left: 72px; top: 461.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.0141);" data-canvas-width="315.1312666666665">in USA is about $165,000, and in order for the valve replacement to</div><div style="left: 72px; top: 475.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00203);" data-canvas-width="243.96133333333333">be successful, patients must abstain from using drugs.</div><div style="left: 72px; top: 500.606px; font-size: 11.3333px; font-family: sans-serif; transform: scaleX(1.07312);" data-canvas-width="46.59133333333333">Methods</div><div style="left: 84px; top: 512.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.979236);" data-canvas-width="304.2977333333332">We examined temporal trends of drug-related visits to hospital</div><div style="left: 72px; top: 525.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.996915);" data-canvas-width="314.69266666666664">EDs, as well as drug-related related ED admissions complicated with</div><div style="left: 72px; top: 539.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.0023);" data-canvas-width="162.72400000000002">endocarditis, bacteremia and sepsis.</div><div style="left: 72px; top: 564.606px; font-size: 11.3333px; font-family: sans-serif; transform: scaleX(1.08488);" data-canvas-width="40.93600000000001">Results</div><div style="left: 84px; top: 576.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.07518);" data-canvas-width="306.71286666666657">The trends in Endocarditis/Sepsis and drug-related related</div><div style="left: 72px; top: 589.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00687);" data-canvas-width="315.01453333333336">admissions appear to echo overdose related ED admissions increase.</div><div style="left: 72px; top: 603.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.976619);" data-canvas-width="314.43879999999996">Patients ED return visits and hospitalizations for the same problem are</div><div style="left: 72px; top: 616.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.01047);" data-canvas-width="314.9646666666667">also growing compare to the previous years. We will discuss the NC</div><div style="left: 72px; top: 629.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00862);" data-canvas-width="315.04399999999987">DETECT case definition used to monitor drug overdose/dependence</div><div style="left: 72px; top: 643.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.995268);" data-canvas-width="314.55440000000004">and infection, case definition transition from ICD-9 to ICD-10 codes,</div><div style="left: 72px; top: 656.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00239);" data-canvas-width="195.78333333333333">and will share surveillance analysis results.</div><div style="left: 72px; top: 681.94px; font-size: 11.3333px; font-family: sans-serif; transform: scaleX(1.10259);" data-canvas-width="68.01133333333334">Conclusions</div><div style="left: 84px; top: 693.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.967312);" data-canvas-width="303.99400000000014">NC DETECT’s system flexibility has been important in rapidly</div><div style="left: 72px; top: 707.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.0361);" data-canvas-width="315.6310666666667">establishing surveillance of infections among drug users. Near real</div><div style="left: 72px; top: 720.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.03343);" data-canvas-width="315.59139999999957">time analysis on hospital, county and state levels can be performed</div><div style="left: 72px; top: 733.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.987835);" data-canvas-width="314.4444666666668">using NC DETECT system reports to provide state officials, hospitals</div><div style="left: 72px; top: 747.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.04117);" data-canvas-width="317.6608666666666">and LHDs with situational awareness. Limitations: Syndromic</div><div style="left: 72px; top: 760.567px; font-size: 11.3333px; font-family: serif; transform: scaleX(0.97472);" data-canvas-width="315.93933333333325">surveillance ED data contains less accurate information about the</div><div style="left: 72px; top: 773.901px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.02514);" data-canvas-width="315.5199999999998">diagnosis codes, procedures, length of stay, and severity comparing</div><div style="left: 72px; top: 787.234px; font-size: 11.3333px; font-family: serif; transform: scaleX(1.00387);" data-canvas-width="135.0366666666667">to the hospital discharge data.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Deyneka, Lana and Hakenewerth, Anne and Faigen, Zachary and Ising, Amy and Barnett, Clifton}, year={2017}, month={May} }