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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Roger Trent, PhD and Arthur Ellis, MA. Injury Surveillance and Epidemiology Section, EPIC Branch, California Department of Health Services, 611 N. 7th Street, MS 39A, P.O. Box 942732, Sacramento, CA 94234-7320, (916) 323-3642, rtrent@dhs.ca.gov
Injury surveillance seldom documents non-injury comorbidities. Some injury comorbidity surveillance has been done with multiple cause of death files. Here we examine non-injury diagnoses in computerized hospital discharge records of patients admitted for an injury. The purpose is 1) to assess the value of hospital discharge records to document injury comorbidity, and 2) to describe comorbidities of all types of injuries. California residents admitted to a hospital for treatment of a new injury had an average of 2.3 non-injury diagnoses. After childhood, the number of these comorbidities rose rapidly with age. Five types of injuries account for 55% of all comorbidities: falls, attempted suicide, environmental, suffocation, and poisoning. Looking within each of these injury types, we found fairly distinct patterns of comorbidities. Among fall patients, for example, common comorbid diagnoses were hypertension, ischemic heart disease, and dysrhythmias. Among attempted suicides, common comorbid diagnoses were drug abuse, depressive disorders, and affective psychoses. Some diagnoses appeared to involve treatment of the injury rather than disease precursors of the injury event. For example, patients with environmental injuries (e.g., exposure to heat or cold) often had diagnoses of volume depletion and electrolyte and acid-base imbalances. We conclude that hospital discharge records are useful for describing injury comorbidity patterns but not the relationship between the injury and the comorbidity. To determine whether a given non-injury condition played the role of injury risk factor, an injury effect, or had no direct relation to the injury at all, the researcher would have examine patient histories in detail.
Learning Objectives:
Keywords: Co-morbid, Surveillance
Presenting author's disclosure statement:
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.