Seil Kacie, Marcum Jennifer, Lall Ramona, Stayton Catherine
Bureau of Environmental Disease and Injury Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA.
, 1100 West 49th Street, Room 704.11, Austin, TX, 78714, USA.
Inj Epidemiol. 2015 Dec;2(1):11. doi: 10.1186/s40621-015-0044-5. Epub 2015 Jun 1.
The New York City emergency department (ED) syndromic surveillance (SS) system provides near real-time data on the majority of ED visits. The utility of ED SS for injury surveillance has not been thoroughly evaluated. We created injury syndromes based on ED chief complaint information and evaluated their utility compared to administrative billing data.
Six injury syndromes were developed: traffic-related injuries to pedal cyclists, pedestrians, and motor vehicle occupants; fall-related injuries; firearm-related injuries; and assault-related stabbings. Daily injury counts were compared for ED SS and the administrative billing data for years 2008-2010. We examined characteristics of injury trends and patterns between the two systems, calculating descriptive statistics for temporal patterns and Pearson correlation coefficients (r) for temporal trends. We also calculated proportions of demographic and geospatial patterns for both systems.
Although daily volume of the injuries varied between the two systems, the temporal patterns were similar (all r values for daily volume exceeded 0.65). Comparisons of injuries by time of day, day of week, and quarter of year demonstrated high agreement between the two systems-the majority had an absolute percentage point difference of 2.0 or less. Distributions of injury by sex and age group also aligned well. Distribution of injury by neighborhood of residence showed mixed results-some neighborhood comparisons showed a high level of agreement between systems, while others were less successful.
As evidenced by the strong positive correlation coefficients and the small absolute percentage point differences in our comparisons, we conclude that ED SS captures temporal trends and patterns of injury-related ED visits effectively. The system could be used to identify changes in injury patterns, allowing for situational awareness during emergencies, timely response, and public messaging.
纽约市急诊科（ED）症状监测（SS）系统提供了大多数急诊就诊的近实时数据。ED症状监测在伤害监测方面的效用尚未得到充分评估。我们根据ED主诉信息创建了伤害综合征，并与行政计费数据相比评估了它们的效用。
制定了六种伤害综合征：与交通相关的骑自行车者、行人及机动车驾乘人员受伤；与跌倒相关的受伤；与枪支相关的受伤；以及与袭击相关的刺伤。比较了2008 - 2010年ED症状监测和行政计费数据的每日伤害计数。我们研究了两个系统之间伤害趋势和模式的特征，计算了时间模式的描述性统计量和时间趋势的Pearson相关系数（r）。我们还计算了两个系统的人口统计学和地理空间模式的比例。
尽管两个系统中伤害的每日数量有所不同，但时间模式相似（每日数量的所有r值均超过0.65）。按一天中的时间、一周中的日期和一年中的季度进行的伤害比较表明，两个系统之间具有高度一致性——大多数的绝对百分点差异为2.0或更小。按性别和年龄组划分的伤害分布也非常吻合。按居住社区划分的伤害分布结果不一——一些社区比较显示系统之间高度一致，而其他社区则不太成功。
正如我们比较中强正相关系数和小绝对百分点差异所证明的那样，我们得出结论，ED症状监测有效地捕捉了与伤害相关的急诊就诊的时间趋势和模式。该系统可用于识别伤害模式的变化，以便在紧急情况下实现态势感知、及时响应和公众信息传递。
