The United States is in the midst of a drug crisis; drug-related overdoses are the leading cause of unintentional death in the country. In Colorado the rate of fatal drug overdose increased 68% from 2002-2014 (9.7 deaths per 100,000 to 16.3 per 100,000, respectively), and non-fatal overdose also increased during this time period (23% increase in emergency department visits since 2011). The CDCâs National Syndromic Surveillance Program (NSSP) provides near-real time monitoring of emergency department (ED) events across the country, with information uploaded daily on patient demographics, chief complaint for visit, diagnosis codes, triage notes, and more. Colorado North Central Region (CO-NCR) receives data for 4 local public health agencies from 25 hospitals across Adams, Arapahoe, Boulder, Denver, Douglas, and Jefferson Counties. Access to local syndromic data in near-real time provides valuable information for local public health program planning, policy, and evaluation efforts. However, use of these data also comes with many challenges. For example, we learned from key informant interviews with ED staff in Boulder and Denver counties, about concern with the accuracy and specificity of drug-related diagnosis codes, specifically for opioid-related overdoses.
Objective:
In order to better describe local drug-related overdoses, we developed a novel syndromic case definition using discharge diagnosis codes from emergency department data in the Colorado North Central Region (CO-NCR). Secondarily, we used free text fields to understand the use of unspecified diagnosis fields.