Recorded presentation

Matthew J. Scholer, MD, PhD, Anna E Waller, ScD, Dennis Falls, BS, and Kate Johnson, MHA, MSIS. North Carolina Emergency Department Database, Department of Emergency Medicine, The University of North Carolina at Chapel Hill, Neurosciences Hospital, Campus Box 7594, Chapel Hill, NC 27599-7594, 919-966-5936, MScholer@med.unc.edu

The North Carolina Emergency Department Database (NCEDD) has developed and implemented a system to collect and analyze timely and secure emergency department data in a centralized database. We report here on the use of this database to construct a syndrome definition of influenza-like-illness (ILI) for the purpose of influenza surveillance. The database was queried for all patient visits with a final ICD9 diagnosis of influenza. Chief complaint and triage nurse notes from these visits were reviewed for common terms related to this diagnosis. Documented triage temperature was also reviewed. These findings were used to construct a definition of influenza-like-illness. Patient visits assigned a final diagnosis code of influenza were compared to the patient visits identified using this definition and to a second definition derived from the CDC’s definition of an ILI. The most commonly identified chief complaints were fever and cold-like symptoms. The most commonly identified terms within the nursing triage notes were related to fever, cough, nausea, vomiting, ache, sore throat and congestion. Documented triage temperature greater than 37.8 was also strongly related to a final diagnosis of influenza. The sensitivity and specificity for detecting influenza patients using the definition of ILI derived from these findings was 51% and 87%, respectively. The syndrome definition based on the CDC’s definition of ILI produced a sensitivity of 43% with a specificity of 92%. The increase in patient visits detected by these definitions during the 2003-2004 influenza epidemic approximated the reports of laboratory proven influenza cases published by the CDC.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the methods used to develop a syndrome definition for the purposes of syndromic surveillance.
• Articulate the definition of influenza-like-illness as described by the CDC.
• List the most common presenting symptoms of patients with influenza to the emergency department.

Keywords: Surveillance, Emergency Department/Room

Related Web page: www.ncedd.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: North Carolina Emergency Department Database (NCEDD)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation