Association of scooter-related injury and hospitalization with electronic scooter sharing systems in the United States.

INTRODUCTION: We used interrupted time series (ITS) analysis to determine whether e-scooter shares' introduction in September 2017 increased serious scooter-related injury across the United States. METHODS: Using the National Electronic Injury Surveillance System, we queried emergency department visits involving motorized scooter-related injuries from January 2010-December 2019. Cases originating where e-scooter shares launched between September 1, 2017-December 1, 2019 (intervention period) were considered exposed. The first month of launch (September 2017) was chosen as the time point for pre- and post-intervention analysis. The primary outcome was change in hospitalizations following scooter injury in association with the month/year launch. RESULTS: This analysis includes 2754 unweighted encounters, representing 102614 estimated injuries involving motorized scooters nationwide. Hospitals within 20 miles of e-scooter shares also experienced a significant monthly increase of 0.24 scooter-related injury hospitalizations/1000 product-related injury hospitalizations ([0.17,0.31]) compared to a non-significant change in hospitalizations of 0.02 [-0.05,0.09] for control hospitals. CONCLUSION: An increase in serious motorized scooter injuries coincides with e-scooter shares' introduction in the US. Future works should explore effective polices to improve public safety.

National Estimates of ENDS Liquid Nicotine Exposures, U.S., 2013-2017.

INTRODUCTION: Increased use of ENDS in the U.S. is related to acute adverse events from liquid nicotine exposure. This paper provides national estimates of U.S. hospital emergency department visits for exposures from liquid nicotine exposure in individuals aged ≥5 years. METHODS: In 2018-2019, data from the 2013-2017 National Electronic Injury Surveillance System All Injury Program were used to identify cases of liquid nicotine-related exposures in individuals aged ≥5 years. National estimates of exposures related to liquid nicotine exposure in ENDS for those aged ≥5 years by demographic characteristics, symptoms, diagnoses, and treatment dispositions were calculated. RESULTS: From 2013 to 2017, an estimated 2,718 cases related to liquid nicotine among those aged ≥5 years were treated in U.S. hospital emergency departments. Most exposures occurred among those who were aged ≥25 years (51.7%), white (74.1%), and male (51.9%). Most case patients were treated and released from the hospitals, and 7.5% were admitted. Poisoning was the most common diagnosis of these exposures (82.7%). The most common symptoms were cardiovascular (29.7%). CONCLUSIONS: This study provides national estimates of emergency department visits for injury and poisoning cases related to nicotine exposure from ENDS among individuals aged ≥5 years. Although long-term health outcome studies of liquid nicotine exposure are not available, these estimates provide some insight into the acute health effects. Findings from this study may inform education programs aimed at preventing exposures related to ENDS products.

National surveillance of emergency department visits for outpatient adverse drug events in children and adolescents.

OBJECTIVE: To describe the national scope and magnitude of outpatient adverse drug events (ADEs) that lead to emergency department (ED) visits in children and adolescents. STUDY DESIGN: To conduct an active surveillance of patients 18 years of age or younger who came to EDs with ADEs from Jan 1, 2004, to Dec 31, 2005, through a nationally representative, stratified probability sample of 63 US hospitals with EDs. The main outcome measures were national estimates of the number, type, patient demographics, and clinical characteristics of ADEs. RESULTS: Annually, an estimated 158,520 patients

National surveillance of emergency department visits for outpatient adverse drug events.

CONTEXT: Adverse drug events are common and often preventable causes of medical injuries. However, timely, nationally representative information on outpatient adverse drug events is limited. OBJECTIVE: To describe the frequency and characteristics of adverse drug events that lead to emergency department visits in the United States. DESIGN, SETTING, AND PARTICIPANTS: Active surveillance from January 1, 2004, through December 31, 2005, through the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project. MAIN OUTCOME MEASURES: National estimates of the numbers, population rates, and severity (measured by hospitalization) of individuals with adverse drug events treated in emergency departments. RESULTS: Over the 2-year study period, 21,298 adverse drug event cases were reported, producing weighted annual estimates of 701,547 individuals (95% confidence interval [CI], 509,642-893,452) or 2.4 individuals per 1000 population (95% CI, 1.7-3.0) treated in emergency departments. Of these cases, 3487 individuals required hospitalization (annual estimate, 117,318 [16.7%]; 95% CI, 13.1%-20.3%). Adverse drug events accounted for 2.5% (95% CI, 2.0%-3.1%) of estimated emergency department visits for all unintentional injuries and 6.7% (95% CI, 4.7%-8.7%) of those leading to hospitalization and accounted for 0.6% of estimated emergency department visits for all causes. Individuals aged 65 years or older were more likely than younger individuals to sustain adverse drug events (annual estimate, 4.9 vs 2.0 per 1000; rate ratio [RR], 2.4; 95% CI, 1.8-3.0) and more likely to require hospitalization (annual estimate, 1.6 vs 0.23 per 1000; RR, 6.8; 95% CI, 4.3-9.2). Drugs for which regular outpatient monitoring is used to prevent acute toxicity accounted for 41.5% of estimated hospitalizations overall (1381 cases; 95% CI, 30.9%-52.1%) and 54.4% of estimated hospitalizations among individuals aged 65 years or older (829 cases; 95% CI, 45.0%-63.7%). CONCLUSIONS: Adverse drug events among outpatients that lead to emergency department visits are an important cause of morbidity in the United States, particularly among individuals aged 65 years or older. Ongoing, population-based surveillance can help monitor these events and target prevention strategies.

Estimates of medical device--associated adverse events from emergency departments.

BACKGROUND: The true public health burden of adverse events associated with medical devices is unknown. The purpose of this study, therefore, was to produce the first-ever national estimates of medical device-associated adverse events resulting in emergency department (ED) visits. METHODS: From July 1999 through June 2000, reports of 10,395 medical device-associated adverse events were accumulated using the National Electronic Injury Surveillance System (NEISS), which collects information on product-related injuries from the ED records of a national stratified probability sample of hospitals. The reports were used to estimate annual total number of medical device-associated adverse events as well as number of adverse events associated with specific devices, injury diagnoses, demographic characteristics, and patient disposition status. RESULTS: The total estimated number of adverse events was 454,383 (95% confidence interval [CI]=371,156-537,610), involving a broad range of devices from 15 medical specialty groups. Unintentional traumatic events associated with a particular device appeared to be the most common mechanism of injury. The most prevalent types of injuries included contusions/abrasions, punctures, and lacerations; 13% of total estimated cases resulted in patient hospitalization. Adverse events occurred within healthcare facilities, and some were occupationally related, although they occurred at home more frequently than any other location (about 42%). CONCLUSIONS: The magnitude of the total estimate, which is over four times greater than the annual number of adverse event reports received by medical device-regulating surveillance systems, emphasizes medical device-associated adverse events as an under-recognized public health problem. Planned collection of more detailed NEISS data will allow for appropriate public health interventions.

Factors associated with the hospital admission of consumer product-related injuries treated in U.S. hospital emergency departments.

While unintentional injuries and hazard patterns involving consumer products have been studied extensively in recent years, little attention has focused on the characteristics of those who are hospitalized after treatment in emergency departments, as opposed to those treated and released. This study quantifies the impact of the age and sex of the injury victims, and other factors, on the likelihood of hospitalization. The analysis focuses on consumer product injuries, and was based on approximately 400,000 injury cases reported through the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, a national probability sample of U.S. hospital emergency departments. Logistic regression was used to quantify the factors associated with the likelihood of hospitalization. The analysis suggests a smooth U-shaped relationship between the age of the victim and the likelihood of hospitalization, declining from about 3.4% for children under age 5 years to 1.9% for 15-24 year-olds, but then rising to more than 25% for those ages 75 years and older. The likelihood of hospitalization was also significantly affected by the victim's sex, as well as by the types of products involved, fire involvement, and the size and type of hospital at which the injury was treated. This study shows that the probability of hospitalization is strongly correlated with the characteristics of those who are injured, as well as other factors.

Unintentional injuries among youth with developmental disabilities in the United States, 2006-2007.

We examined unintentional injury among youth with and without developmental disabilities. Our nationally representative sample included 6369 injured youth, aged 0-17 years, who were seen in one of the 63 US hospital emergency rooms that participated in the National Electronic Injury Surveillance System - All Injury Program (NEISS-AIP) in 2006-2007. Parents or guardians of injured youth were interviewed by telephone after the hospital visit to ascertain disability status. Denominator data were obtained from the National Health Interview Survey. Leading causes of injury were comparable for youth with and without disability. Injury rates (per 100 youth per year) were also comparable [10.4; 95% confidence interval (CI) 7.8, 13.0 and 10.5; 95% CI 8.2, 12.9, for youth with and without disability, respectively]. When examined by specific disability, the rate ratio for youth with learning disabilities versus youth without learning disability was 1.57 (95% CI 1.04, 2.10), which may represent a subgroup for targeted interventions.