scholarly journals A Comparison of Fever Classified Chief Complaints and Diagnoses with Recorded Body Temperatures

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Patricia Araki ◽  
Emily Kajita ◽  
Kelsey OYong ◽  
Monica Z. Luarca ◽  
Bessie Hwang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Los Angeles ◽  
Syndromic Surveillance ◽  
Los Angeles County ◽  
Body Temperatures ◽  
Emergency Department Data ◽  
Chief Complaints

In an effort to evaluate patient stated "fever" chief complaints and diagnoses utilizing emergency department data from the Los Angeles County Syndromic Surveillance project, each were compared with measured patient body temperatures in the fever range.

scholarly journals Validation of Los Angeles County Department of Public Health Respiratory Syndrome using Electronic Health Records

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Kelsey OYong ◽  
Emily Kajita ◽  
Patricia Araki ◽  
Monica Luarca ◽  
Bessie Hwang
Keyword(s):  
Emergency Department ◽  
Los Angeles ◽  
Electronic Health Records ◽  
Syndromic Surveillance ◽  
Los Angeles County ◽  
Surveillance Systems ◽  
Health Records ◽  
High K ◽  
Chief Complaints ◽  
Electronic Health

In Los Angeles County, emergency department data is collected from hospitals and classified into syndromes based on chief complaints. To validate this respiratory syndromic surveillance categorization, chief complaint data were compared to discharge diagnoses extracted from electronic health records from one hospital emergency department in Los Angeles County during one week in January 2013. The agreement between syndrome classification and discharge diagnosis for respiratory reports is high (k=0.75), though over 25% of diagnosis data were missing. Further validation of additional syndromes is needed. Electronic health records are valuable sources of data and can enhance the validity of syndromic surveillance systems.

scholarly journals Monitoring Heat-Related Illness through Syndromic Surveillance in Los Angeles County

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Jimmy Duong ◽  
Michael Lim ◽  
Emily Kajita ◽  
Bessie Hwang
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Syndromic Surveillance ◽  
Los Angeles County ◽  
Correlation Coefficients ◽  
Temperature Data ◽  
Extreme Heat ◽  
Chief Complaints ◽  
Ed Visits ◽  
Council Of State

ObjectiveTo analyze Los Angeles County’s (LAC) extreme heat season in 2018 and evaluate the Council of State and Territorial Epidemiologists’ (CSTE) syndrome query for heat-related-illness (HRI) in Los Angeles County (LAC)IntroductionLAC experienced several days of record-breaking temperatures during the summer of 2018. Downtown Los Angeles temperatures soared to 108°F in July with an average daily maximum of 92°F. Extreme heat events such as these can pose major risks to human health. Syndromic surveillance can be a useful tool in providing near real-time surveillance of HRI. In 2014, a working group was formed within the CSTE Climate Change Subcommittee to define and analyze HRI. The workgroup’s goal was to provide guidance to public health professionals in adapting and implementing an HRI syndrome surveillance query. The Acute Communicable Disease Control Program’s (ACDC) Syndromic Surveillance Unit utilized CSTE’s HRI query to provide surveillance during the extreme heat season in 2018 in LAC. Additional modifications to the CSTE query were evaluated for potential improvements towards characterizing HRI trends.MethodsFrom May 1 to September 30, 2018, Emergency Department (ED) data were queried for cases using the CSTEs definition for HRI. The queries consisted of key word searches within the chief complaint (CC) data field, and, if available, the diagnosis data fields. The query was derived from the CSTE HRI query published in 20161. In addition, ACDC explored the utility of expanding the CSTE syndrome definition to include additional chief complaints commonly associated with HRI such as dehydration and syncope. Both queries were applied on all participating syndromic EDs in LAC alongside daily high temperature data trends. Local temperature data for downtown Los Angeles weather station KCQT were taken from the Weather Underground website. Spearman correlation coefficients were calculated for each query during the heat season. Similarly, both queries were also applied during colder months from October 1, 2017 to April 30, 2018 for comparison. Lastly, results for dehydration and syncope were independently assessed apart from other HRI query terms during both heat seasons and colder months.ResultsThe CSTE HRI query and the query with the added terms yielded 1,258 and 63,332 ED visits, respectively, during the heat season. On July 6, the maximum daily temperature peaked at 108 °F; the HRI and the query with the added terms yielded 136 and 618 ED visits, respectively. The HRI query and the HRI query with the added terms had a correlation coefficient of 0.714 (p <0.0001) and 0.427 (p <0.0001), respectively. During colder months, the CSTE HRI query and the query with the added terms yielded 377 and 86,008, respectively, with correlation coefficients of 0.342 (p < 0.0001) and 0.133 (p < 0.052). The syncope-only query saw no variation in HRI classified encounters throughout the heat season (mean: 328; min: 228; max: 404) or colder months (mean: 328; min: 261; max: 404) with correlation coefficients of 0.238 (p = 0.003) and 0.155 (p = 0.024), respectively. Similarly, the dehydration-only query saw no variation in HRI classified encounters throughout the heat season (mean: 96; min: 58; max: 258) or colder months (mean: 94; min: 60; max: 160) with correlation coefficients of 0.596 (p < 0.0001) and -0.016 (p = 0.822).ConclusionsThe CSTE HRI query proved to be a strong indicator for HRI, and the addition of terms associated with dehydration and syncope to the CSTE HRI query weakened the correlation with temperature. Compared to the original CSTE HRI query, the added terms yielded a 4934% increase in HRI classified encounters during the heat season; however, these were likely due to causes other than HRI -- adding the extra terms resulted in a weaker correlation with temperature. Additionally, the comparative analysis showed that, with the added terms, the volume of HRI encounters was larger during colder months than hotter months suggesting misclassification of non-HRI illnesses. Surveillance of HRI has proven to be difficult because many of the HRI symptoms are too commonly associated with non-HRI conditions which would explain the weaker correlations when adding additional chief complaints associated with HRI. In conclusion, the CSTE syndrome definition for HRI proved to be the most robust query for HRI during the heat season. Case counts of HRI are difficult due to symptom overlap with many other medical conditions. However, syndromic surveillance using the CSTE HRI query is useful for trend analysis in near real-time during heat events.References1. Council of State and Territorial Epidemiologists. Heat-Related Illness Syndrome Query: A Guidance Document for Implementing Heat-Related Illness Syndromic Surveillance in Public Health Practice. Version 1.0. 2016 Sep. 12 p. 

scholarly journals Harnessing Syndromic Surveillance Emergency Department Data to Monitor Health Impacts During the 2015 Special Olympics World Games

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 99S-105S ◽  
Author(s):  
Emily Kajita ◽  
Monica Z. Luarca ◽  
Han Wu ◽  
Bessie Hwang ◽  
Laurene Mascola
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Los Angeles County ◽  
International Travel ◽  
Poison Control ◽  
Special Olympics ◽  
Syndromic Surveillance System ◽  
Mass Gatherings

Introduction: Mass gatherings that attract a large international presence may cause or amplify point-source outbreaks of emerging infectious disease. The Los Angeles County Department of Public Health customized its syndromic surveillance system to detect increased syndrome-specific utilization of emergency departments (EDs) and other medical encounters coincident to the 2015 Special Olympics World Games. Materials and Methods: We queried live databases containing data on ED visits, California Poison Control System calls, and Los Angeles County coroner-investigated deaths for increases in daily counts from July 19 to August 6, 2015. We chose syndrome categories based on the potential for disease outbreaks common to international travel and dormitory settings, morbidity amplified by high temperatures, and bioterrorism threats inherent to mass gatherings. We performed line-list reviews and trend analyses of total, syndrome-specific, and region-specific daily counts, using cumulative sum-based signals. We also piloted a novel strategy of requesting that ED registrars proactively tag Special Olympics attendees in chief complaint data fields. Results: The syndromic surveillance system showed that the 2015 Special Olympics did not generate large-scale acute morbidities leading to detectable stress on local EDs. We recruited 10 hospitals for proactive patient tagging, from which 16 Special Olympics attendees were detected; these patients reported various symptoms, such as injury, vomiting, and syncope. Practice Implications: As an enhancement to traditional syndromic surveillance, proactive patient tagging can illuminate potential epidemiologic links among patients in challenging syndromic surveillance applications, such as mass gatherings. Syndromic surveillance has the potential to enhance ED patient polling and reporting of exposure, symptom, and other epidemiologic case definition criteria to public health agencies in near-real time.

scholarly journals Using routine emergency department data for syndromic surveillance of acute respiratory illness before and during the COVID-19 pandemic in Germany, week 10-2017 and 10-2021

2021 ◽  
Author(s):  
T Sonia Boender ◽  
Wei Cai ◽  
Madlen Schranz ◽  
Theresa Kocher ◽  
Birte Wagner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Syndromic Surveillance ◽  
Virus Disease ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
Case Definitions ◽  
Emergency Department Data ◽  
Duration Magnitude ◽  
Icd 10

Introduction: To better assess the epidemiological situation of acute respiratory illness in Germany over time, we used emergency department data for syndromic surveillance before and during the COVID-19 pandemic. Methods: We included routine attendance data from emergency departments who continuously transferred data between week 10-2017 and 10-2021, with ICD-10 codes available for >75% of the attendances. Case definitions for acute respiratory illness (ARI), severe ARI (SARI), influenza-like illness (ILI), respiratory syncytial virus disease (RSV) and Coronavirus disease 2019 (COVID-19) were based on a combination of ICD-10 codes, and/or chief complaints, sometimes combined with information on hospitalisation and age. Results: We included 1,372,958 attendances from eight emergency departments. The number of attendances dropped in March 2020, increased during summer, and declined again during the resurge of COVID-19 cases in autumn and winter of 2020/2021. A pattern of seasonality of acute respiratory infections could be observed. By using different case definitions (i.e. for ARI, SARI, ILI, RSV) both the annual influenza seasons in the years 2017-2020 and the dynamics of the COVID-19 pandemic in 2020-2021 were apparent. The absence of a flu season during the fall and winter of 2020/2021 was visible, in parallel to the resurge of COVID-19 cases. The proportion of SARI among ARI cases peaked in April-May 2020 and November 2020-January 2021. Conclusion: Syndromic surveillance using routine emergency department data has the potential to monitor the trends, timing, duration, magnitude and severity of illness caused by respiratory viruses, including both influenza and SARS-CoV-2.

scholarly journals Seasonal Patterns in Syndromic Surveillance Emergency Department Data due to Respiratory Illnesses

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Kelly Johnson ◽  
Alecia Alianell ◽  
Rachel Radcliffe
Keyword(s):  
Emergency Department ◽  
South Carolina ◽  
Early Detection ◽  
Syndromic Surveillance ◽  
Seasonal Patterns ◽  
Prevention Strategies ◽  
Respiratory Illnesses ◽  
Seasonal Trends ◽  
Emergency Department Data

This abstract assesses the seasonal trends in respiratory illnesses using South Carolina syndromic surveillance emergency department data. The use of syndromic surveillance emergency department data to track respiratory illnesses is useful for the early detection of illness clusters in a particular area and for the development of prevention strategies in preparation of increases in respiratory illnesses.

scholarly journals Implementation of Targeted Temperature Management After Out‐of‐Hospital Cardiac Arrest: Observations From the Los Angeles County Regional System

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Melody Hermel ◽  
Nichole Bosson ◽  
Andrea Fang ◽  
William J. French ◽  
James T. Niemann ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Los Angeles ◽  
Los Angeles County ◽  
The United States ◽  
System Of Care ◽  
Temperature Management ◽  
Factors Associated ◽  
Regional System ◽  
Hospital Cardiac Arrest

Background Despite the benefits of targeted temperature management (TTM) for out‐of‐hospital cardiac arrest), implementation within the United States remains low. The objective of this study was to evaluate the prevalence and factors associated with TTM use in a large, urban‐suburban regional system of care. Methods and Results This was a retrospective analysis from the Los Angeles County regional cardiac system of care serving a population of >10 million residents. All adult patients aged ≥18 years with non‐traumatic out‐of‐hospital cardiac arrest transported to a cardiac arrest center from April 2011 to August 2017 were included. Patients awake and alert in the emergency department and patients who died in the emergency department before consideration for TTM were excluded. The primary outcome measure was prevalence of TTM use. The secondary analysis were annual trends in TTM use over the study period and factors associated with TTM use. The study population included 8072 patients; 4154 patients (51.5%) received TTM and 3767 patients (46.7%) did not receive TTM. Median age was 67 years, 4780 patients (59.2%) were men, 4645 patients (57.5%) were non‐White, and the most common arrest location was personal residence in 4841 patients (60.0%). In the adjusted analysis, younger age, male sex, an initial shockable rhythm, witnessed arrest, and receiving coronary angiography were associated with receiving TTM. Conclusions Within this regional system of care, use of TTM was higher than previously reported in the literature at just over 50%. Use of integrated systems of care may be a novel method to increase TTM use within the United States.

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