Carbon Monoxide Exposure V2 - Kansas Department of Health and Environment

KDHE has updated the exhisting CO Poisoning Surveillance queries. Version 1 can be found here https://www.surveillancerepository.org/carbon-monoxide-exposure-kansas-d...

Previously, we were querying for carbon monoxide-related cases by using the NSSP ESSENCE SubSyndrome for COPoisoning coupled with an ICD10 CM diagnosis code query. SubSyndrome and ICD10 queries had to be run separately and then combined and de-duplicated.

The COPoisoning SubSyndrome does a fairly good job and we captured cases reliably from this method. If something wasn’t picked up by the SubSyndrome, we had a second chance after ICD10 CM diagnosis codes came in at a later point.

The downsides to this SubSyndrome were that it searched only the Chief  Complaint Parsed field and only looked for the terms CARBON, CO POISON, and COPOISON. Furthermore, the diagnosis code portion needed SNOMED CT codes added, another diagnosis code system we found being sent through our KSSP data feeds.

To enhance the free-text side of the query, the following terms were tested and performed well:^CARBON[\/.; ]^,or,^CARBONM^,or,^CARBON,or,^COPOIS^,or,^CO POIS^,or,^COTOX^,or,^CO TOX^,or,^MONOX^,or,^C0POIS^,or,^C0 POIS^,or,^C0TOX^,or,^C0 TOX^,or,^CO2 pois^,or,^CO2POIS^,or,^CO2TOX^,or,^CO2 TOX,or,^C02 POIS^,or,^C02POIS^,or,^C02TOX^,or,^C02 TOX^

To further enhance the free-text side of the query, the query fields were expanded to include the following:
Chief Complaint, Chief Complaint History, Triage Notes, Admit Reason Combo, SubSyndrome Free Text, and Clinical Impression

Since current ICD10 CM queries were unable to return visits to hospitals submitting SNOMED CT codes for discharge diagnosis, the Discharge Diagnosis Combo field was queried to return all SNOMED CT codes with a description related to carbon monoxide. Because including all SNOMED codes related to CO poisoning would be prohibitively long, this method identified those CO poisoning codes utilized by hospitals sending SNOMED CT codes. These codes were combined with the previous ICD10 CM code and executed on the Discharge Diagnosis History field:
^95875007^,or,^17383000^,or,^242840004^,or,^T58^

Finally, current NSSP ESSENCE updates have allowed for querying across multiple fields (as used in the free text query) which allowed the following code to cover all fields mentioned in the above descriptions and removed the need for de-duplicating the data.

 

System - NSSP ESSENCE

Data Source - ED Visits

Fields Used - CHief Complaints Parsed, Chief Complaint History, SubSyndrome Free Text, Clinical Impression, Admit Reason Combo, Discharge Diagnosis History

Surveillance System: 
ESSENCE (NSSP)
Syndrome Definition: 

^CARBON[\/.; ]^,or,^CARBONM^,or,^CARBON,or,^COPOIS^,or,^CO POIS^,or,^COTOX^,or,^CO TOX^,or,^MONOX^,or,^C0POIS^,or,^C0 POIS^,or,^C0TOX^,or,^C0 TOX^,or,^CO2 pois^,or,^CO2POIS^,or,^CO2TOX^,or,^CO2 TOX,or,^C02 POIS^,or,^C02POIS^,or,^C02TOX^,or,^C02 TOX^,or,^95875007^,or,^17383000^,or,^242840004^,or,^T58^

Attached Syntax Platform: 
ESSENCE
Author: 
Submitting Author Organization: 
Kansas Department of Health and Environment
Submitting Author Email: 
Zach.Stein@ks.gov
Syndrome Category: 

September 24, 2018

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