ED Overdoses in 2023
Syndromic surveillance data includes all Illinois acute care hospital emergency department (ED) visits. Data presented in the dashboard is provisional. Data is submitted to IDPH in near real-time. County-level data includes visits based on where the patient lives in Illinois.
Definition of Overdose: Opioid overdoses are inclusive of heroin overdoses. Visits are classified as overdoses due to opioid and/or heroin based on searches of both chief complaint text and/or diagnosis codes. Based on CDC guidance, diagnosis codes for poisoning and intoxication are included, as well as diagnosis codes that indicate opioid abuse, when symptoms associated with overdose are also reported at the ED visit.
The definition for opioid overdose and heroin overdose are summarized in the tables below.
Limitations of the data:
- Cause: Toxicology results are not available for use in identifying cause of overdose in syndromic data. Cause cannot be differentiated between prescription or illicit opioid overdoses, nor fentanyl use or contamination.
- Timing. Submission and processing of ED data can lag by up to 24 hours before it is included in the analysis. Longer delays in reporting of diagnosis for a visit can affect the time it takes to identify a visit due to opioids, and may initially show a decrease in overdoses in recent days until all information is received.
- Representativeness: Overdoses that occur in other settings (i.e. home, EMS, out of state) are not identified.
- Methods: Differences between ED statistics from syndromic and hospital discharge data sources are due to variations in the methods of data collection and comparisons should not be made across data sets.
Table 1. Chief complaint and discharge diagnosis search terms for suspected opioid overdose
Variable |
Automatic inclusion? |
Specific terms |
Inclusions |
|
|
Discharge Diagnosis - ICD-9-CM poisoning |
Yes |
965.00, 965.01, 965.02, 965.09, E850.0, E850.1, E850.2 (also included terms with no period, e.g., "96500") |
Discharge Diagnosis - ICD-10-CM poisoning |
Yes |
T40.1X1A, T40.1X4A, T40.0X1A, T40.0X4A, T40.2X1A, T40.2X4A, T40.3X1A, T40.3X4A, T40.4X1A, T40.4X4A, T40.601, T40.604, T40.691, T40.694 (also included terms with no period, e.g., "T401X1A") |
Discharge Diagnosis - ICD-10-CM opioid abuse/dependence/use with intoxication |
Yes |
F11.12, F11.120, F11.121, F11.122, F11.129, F11.22, F11.220, F11.221, F11.222, F11.229, F11.92, F11.920, F11.921, F11.922, F11.929 (also included terms with no period, e.g., "F1112") |
Discharge Diagnosis - SNOMED |
Yes |
295174006, 295175007, 295176008, 295165009, 242253008, 297199006, 295213004 |
Chief complaint - narcan or naloxone |
Yes |
Naloxone (narcan, evzio) |
Chief complaint - overdose term |
No, must use in combination with opioid term |
Poisoning (poison)
Overdose (overdose, overdoes, averdose, averdoes, over does, overose)
Nodding off
Snort
Ingestion (ingest, injest)
Intoxication (intoxic)
Unresponsive (unresponsiv)
Loss of consciousness (syncopy, syncope)
Shortness of breath (SOB), short of breath
Altered mental status (AMS)
|
Chief complaint - opioid term |
No, must use in combination with overdose term |
opioid, opiod, opoid, opiate, opate, opium, opium, opum, heroin, herion, heroine, HOD, speed ball, speedball, dope, methadone, suboxone, oxyco, oxy, oxyi, percoc, vicod, fent, hydrocod, morphin, codeine, codiene, codene, oxymor, dilaud, hydromor, tramad, suboxin, buprenorphine, and other common opioid brand and generic names |
Discharge Diagnosis - ICD-10-CM opioid abuse/dependence/use |
No, must use in combination with overdose term |
F11.10, F11.90, F11.20 |
Exclusions |
|
|
Chief complaint |
Exclude |
See list below in ESSENCE code (many exclusions were required for "oxy" and "fent") |
Table 2. Chief complaint and discharge diagnosis search terms for suspected heroin overdose
Variable |
Automatic inclusion? |
Specific terms |
Inclusions |
|
|
Discharge Diagnosis - ICD-9-CM poisoning |
Yes |
965.01, E850.0 (also included terms with no period, e.g., "96501") |
Discharge Diagnosis - ICD-10-CM poisoning |
Yes |
T40.1X1A, T40.1X4A (also included terms with no period, e.g., "T401X1A") |
Discharge Diagnosis - SNOMED |
Yes |
295174006, 295175007, 295176008 |
Chief complaint - overdose term |
No, must use in combination with opioid term |
Poisoning (poison)
Overdose (overdose, overdoes, averdose, averdoes, over does, overose)
Nodding off
Snort
Ingestion (ingest, injest)
Intoxication (intoxic)
Unresponsive (unresponsiv)
Loss of consciousness (syncopy, syncope)
Shortness of breath (SOB), short of breath
Altered mental status (AMS)
|
|