Proescholdbell Scott

The opioid overdose crisis has rapidly expanded in North Carolina (NC), paralleling the epidemic across the United States. The number of opioid overdose deaths in NC has increased by nearly 40% each year since 2015.1 Critical to preventing overdose deaths is increasing access to the life-saving drug naloxone, which can reverse overdose symptoms and progression. Over 700 EMS agencies across NC respond to over 1,000,000 calls each year; naloxone administration was documented in over 15,000 calls in 2017.2 Linking EMS encounters with naloxone administration to the corresponding ED visit assists in understanding the health outcomes of these patients. However, less than 66% of NC EMS records with naloxone administration in 2017 were successfully linked to an ED visit record. This study explored methods to improve EMS and ED data linkage, using a multistage process to maximize the number of correctly linked records while avoiding false linkages.

Objective: To improve linkage between North Carolina's Emergency Medical Services (EMS) and Emergency Department (ED) data using an iterative, deterministic approach.

In North Carolina there has been an escalation of poisoning deaths. In 2011, the number of fatal poisonings was 1,368 deaths, with 91% classified as drug overdoses with the majority of those due to opioid analgesics.[1] Far greater numbers of drug overdoses result in hospitalization, emergency department (ED) or outpatient clinic visits, or resolve without the individual seeking medical attention. Although public health authorities have long employed death data for drug overdose surveillance in NC, little attention has been paid to the use of ED data for this purpose. Through the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), NC collects information on 99.5% of all acute-care ED visits across the state, primarily for syndromic surveillance purposes. Despite the timeliness and completeness of this data system, drug overdose surveillance is a challenge due to lack of a standardized definition for the positive identification of opioid overdoses. In this study we used NC DETECT ED data to describe visits due to drug, and more specifically, opioid overdoses. Objective: To describe the epidemiologic characteristics for emergency department visits due to drug overdoses in North Carolina.

Falls are a leading cause of fatal and nonfatal injury in NC. As the size of the older adult population is predicted to increase over the next few decades, it is likely that the incidence of falls-related morbidity and mortality will increase in tandem. In order to address this public health emergency, the Injury and Violence Prevention Branch (IVPB) of the NC Division of Public Health has partnered with the Carolina Center for Health Informatics (CCHI) in the Department of Emergency Medicine at the University of North Carolina at Chapel Hill to perform falls surveillance activities. This abstract describes some of the specific research and surveillance activities currently ongoing in NC.

Objective:

To describe how a successful partnership between state public health and a university organization has used epidemiologic data, such as mortality, hospital discharge, and emergency department (ED) visit data, to inform falls prevention activities in North Carolina (NC).

Violence-related injuries are a major source of morbidity and mortality in NC. From 2005-2014, suicide and homicide ranked as NC's 11th and 16th causes of death, respectively. In 2014, there were 1,932 total violent deaths, of which 1,303 were due to suicide (67%), 536 due to homicide (28%), and 93 due to another mechanism of violent injury (5%). These deaths represent a fraction of the total number of violence-related injuries in NC.1 This study examined ED visit data captured by NC DETECT to identify and describe violent injuries treated in NC EDs and compare/contrast with fatalities reported by NC-VDRS.

Objective:

To describe violent injuries treated in North Carolina (NC) emergency departments (EDs) and compare to deaths reported by the NC Violent Death Reporting System (NC-VDRS).