Research Update: NEISS

Feasibility of Expanding NEISS to Monitor Nonfatal Injuries Treated in< US Emergency Departments

 

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. Annals of Emergency Medicine November 1999;34:637-645.

Researchers from the Centers for Disease Control and Prevention CDC) and the US Consumer Product Safety Commission recently assessed whether the National Electronic Injury Surveillance System (NEISS) could be expanded to provide nationally representative data on all nonfatal injuries treated in U.S. emergency departments (EDs). Currently the NEISS is used to monitor only ED-treated consumer product-related injuries in the United States. All persons receiving first-time treatment for an injury were monitored during a 3-month period of 1997 at a representative sample of 21 NEISS hospital EDs. To evaluate the data collection effort, a sensitivity study was conducted at six of the hospitals.

New System Could Provide Important National Estimates

The results of the pilot demonstrated that national estimates of ED-treated nonfatal injury by all types and external causes could be generated by the expansion of NEISS. In addition, these nonfatal injuries can be characterized by age and sex of injured person, intent (i.e., unintentional injury, assault, intentionally self-inflicted injury), location where injury occurred (e.g., home), body part affected, diagnosis, and whether the person was hospitalized or treated and released.

Ongoing surveillance of nonfatal injuries would be valuable for prioritizing national prevention efforts, especially for injuries which are severe but not often fatal (see table below). Such a system would also allow for identification of high-risk groups, monitoring of trends, and evaluation of prevention programs.

Study Sensitivity

At 6 of the 21 hospitals in the pilot, researchers conducted a sensitivity study. These six hospitals were dispersed geographically and varied in size. Results showed that of the 593 cases of injury detected by CDC researchers, 490 were detected by NEISS coders for an overall sensitivity of 82.6% . For the five most common injury mechanisms, agreement in classification ranged from 100% for motor vehicle/traffic occupant injuries to 76.2% for overexertion injuries. This sensitivity and agreement in classification was achieved despite a doubling of the number of cases and no additional coders during the 3-month pilot.

Rank	Age (years)
	0-4	5-9	10-14	15-19	20-24	25-34	35-44	45-54	55-64	65+	Total
1	Fall 854,000	Fall 600,000	Struck by/ against 592,000	Struck by/against 556,000	Struck by/against 457,000	Over- exertion 820,000	Fall 760,000	Fall 609,000	Fall 413,000	Fall 1,797,000	Fall 7,007,000
2	Struck by/ against 393,000	Struck by/ against 486,000	Fall 464,000	MV, traffic 514,000	MV, traffic 450,000	Struck by/ against 814,000	Over- exertion 639,000	Struck by/ against 327,000	MV, traffic 196,000	Struck by/ against 242,000	Struck by/ against 4,675,000
3	Cut/pierce 205,000	Cut/pierce 288,000	Cut/pierce 276,000	Fall 379,000	Over- exertion 420,000	Fall 761,000	Struck by/ against 622,000	MV, traffic 314,000	Struck by/ against 186,000	MV, traffic 189,000	Cut/ pierce 3,401,000

Table: Three leading causes of nonfatal injuries treated in U.S. hospital emergency departments by age group. All Injury Study, 1997. Numbers in each group category represent estimated annual number of ED-treated injuries for that cause.