Objective Linking data between violent death decedents and other sources can provide valuable insight, highlighting opportunities for prevention of violent injury. This study investigated the feasibility of linking North Carolina Violent Death Reporting System (NC-VDRS) records with North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) emergency department (ED) visit data to identify prior-month ED visits among this population.
Methods NC-VDRS death records from 2019 through 2020 were linked to NC DETECT ED visit data from December 2018 through 2020 using a probabilistic linkage approach. Linkage variables included date of birth, age, sex, zip code and county of residence, date of event (death/ED visit) and mechanism of injury. Potential linkable ED visits were filtered to those occurring in the month prior to death and manually reviewed for validity. Linked records were compared with the NC-VDRS study population to assess linkage performance and generalisability.
Results Among the 4768 violent deaths identified, we linked 1340 NC-VDRS records to at least one ED visit in the month prior to death. A higher proportion of decedents dying in medical facilities (ED/outpatient, hospital inpatient, hospice or nursing/long-term care facility) linked to a prior-month visit (80%) relative to those dying in other locations (12%). When stratified by place of death, linked decedents demographically resembled the overall NC-VDRS study population.
Conclusions Though resource intensive, an NC-VDRS-to-NC DETECT linkage was successful in identifying prior-month ED visits among violent death decedents. This linkage should be leveraged to further analyse ED utilisation prior to violent death, expanding the knowledge base surrounding prevention opportunities for violent injuries.
Data availability statement
No data are available. Data are not available for sharing.
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Contributors LMN and KJH led and MDF and AEW contributed to the conceptualisation and design of the study. LMN cleaned and linked the data. LMN, LCJ and MDF analysed the data. LMN led and LCJ assisted in drafting the initial manuscript. All authors contributed to interpreting the data and revising the manuscript. KJH accepts full responsibility for preparation and submission of the manuscript as guarantor.
Funding This work was partly supported by an AHPA/CDC Data Science Demonstration Project Award (2022-0007) to the University of North Carolina Injury Prevention Research Center.
Disclaimer CDC/APHA disclaimer: The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the CDC and/or APHA. NC DETECT data attribution and disclaimer: NC DETECT is a state-wide public health syndromic surveillance system, funded by the NC Division of Public Health (NC DPH) Federal Public Health Emergency Preparedness Grant and managed through collaboration between NC DPH and UNC-CH Department of Emergency Medicine’s Carolina Center for Health Informatics. The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses or conclusions presented.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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