Expanding the National Electronic Injury Surveillance System to Monitor All Nonfatal Injuries Treated in US Hospital Emergency Departments,☆☆

Presented in part at the 4th World Conference on Injury Control, Amsterdam, The Netherlands, May 1998.
https://doi.org/10.1016/S0196-0644(99)70166-6Get rights and content

Abstract

Study objective: Injury is a major cause of morbidity and mortality in the United States. Although the National Vital Statistics System provides data on injury-related deaths, a national surveillance system is needed for timely identification of emerging nonfatal injury problems and continuous monitoring of severe nonfatal injuries. This work assesses the feasibility of expanding the National Electronic Injury Surveillance System (NEISS) to monitor all types and causes of nonfatal injuries treated in US hospital emergency departments and reports national estimates generated by a pilot study of this system. Methods: At a stratified sample of US hospital EDs, persons receiving first-time treatment for an injury were monitored from May 1 through July 31, 1997. National estimates of the annual number and rate of ED-treated injuries overall, by patient characteristics, injury diagnosis, and external cause of injury were generated, and the sensitivity of the system for detecting ED-treated injuries was assessed. Results: An estimated 29.1 million injuries were treated in US EDs in 1997 (rate of 108.6/1,000 population). The leading causes of injury were falls, being struck by or striking against an object or person, cutting or piercing, and motor vehicle traffic. Of 593 cases of injury detected by investigators from the Centers for Disease Control and Prevention during visits to 6 of the 21 NEISS hospitals in the study, 490 were also detected by NEISS coders for an overall sensitivity of 82.6%. Conclusion: Expanding the NEISS is a feasible means of timely and continuous monitoring of all types and causes of nonfatal injuries treated in US hospital EDs. [Quinlan KP, Thompson MP, Annest JL, Peddicord J, Ryan G, Kessler EP, McDonald AK: Expanding the National Electronic Injury Surveillance System to monitor all nonfatal injuries treated in US hospital emergency departments. Ann Emerg Med November 1999;34:637-645.]

Section snippets

INTRODUCTION

Injuries contribute significantly to mortality and morbidity in the United States.1 In 1996, unintentional injury ranked fifth among the leading causes of death for the overall US population1 and was the leading cause of death for persons aged 1 to 34 years.2 In that year, homicide was the second leading cause of death for persons aged 15 to 24 years, and suicide was the ninth leading cause of death for the nation as a whole.1 For every injury-related death, there were an estimated 18

MATERIALS AND METHODS

The NEISS, maintained and operated by the US Consumer Product Safety Commission (CPSC), is an ongoing surveillance system routinely used to monitor consumer product-related injuries treated in US hospital EDs.10 There are currently 101 NEISS hospital EDs that represent a probability sample of all US and US territory hospitals that have at least 6 beds and provide 24-hour emergency services.11 Sixty-five of these hospitals comprised the NEISS sample in 1990. These 65 hospitals are nationally

RESULTS

From May 1, 1997, through July 31, 1997, 32,423 cases of injury were reported at the 21 hospitals in the pilot. Based on weighted NEISS data, we estimate 29.1 million nonfatally injured persons were treated in US hospital EDs in 1997 (rate of 108.6/1,000 population). Table 1 shows the percentage distributions and rates by sex and age.

. Estimates of the annual number, percent distribution, and rate of nonfatal injuries treated in US hospital EDs, 1997.*

CharacteristicNumber (in thousands)Empty Cell

DISCUSSION

Expanding the NEISS to monitor all types and causes of injuries treated in US EDs is feasible and advantageous. If instituted on an ongoing basis, this system could provide continuous surveillance of severe nonfatal injuries. Such monitoring would be useful to follow national trends, evaluate national interventions, and identify emerging injury problems. For any emerging injury problem, NEISS allows for timely identification of new cause-specific injury patterns and timely follow-up

Acknowledgements

We thank Dan Sosin, MD, MPH, and Joe Sniezek, MD, MPH, for help in conceptualizing this project; Bruce Jones for his thoughtful review of the manuscript; and Ballarami Valluru, MS, for statistical assistance. We also thank the NEISS supervisors and field staff for their diligence in collecting high-quality surveillance data and Helen Jakimenko of CDC for her assistance with data entry.

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  • Cited by (0)

    Address for reprints: Kyran P Quinlan MD, MPH, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-63, Atlanta, GA 30341-3714; 770-488-4648, fax 770-488-1317; E-mail [email protected].

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