Proposed Framework for Presenting Injury Data Using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Diagnosis Codes.

Frameworks based on the International Classification of Diseases (ICD) provide injury researchers and epidemiologists with standard approaches for presenting and analyzing injury-related mortality and morbidity data. Injury diagnosis frameworks, such as the Barell Matrix for the ICD Ninth Revision, Clinical Modification (ICD-9-CM) and the Injury Mortality Diagnosis Matrix for the ICD Tenth Revision (ICD-10), categorize ICD codes into major body region (e.g., head, chest, abdomen, or extremity) by nature-of-injury (e.g., fracture, laceration, organ injury, or vascular injury) categories. In the United States, morbidity coding transitioned from ICD-9- CM to ICD-10-CM on October 1, 2015. In preparation for the use of ICD-10-CMcoded morbidity data for injury surveillance and data analysis, the National Center for Health Statistics and the National Center for Injury Prevention and Control propose an ICD-10-CM Injury Diagnosis Matrix to provide a standard approach for categorizing injuries by body region and nature of injury. This report provides a brief description of the differences between ICD-9-CM and ICD-10-CM injury diagnosis codes, introduces the proposed framework and the methods used to create it, and provides a list of additional considerations for review and comment by researchers and subjectmatter experts in injury data and surveillance.

Nonfatal natural and environmental injuries treated in emergency departments, United States, 2001-2004.

Exposure to adverse natural and environmental events (eg, extreme temperatures and disasters) poses a public health burden when resulting in injuries requiring emergency care. We examined the incidence and characteristics of persons with environmental exposure-related injuries treated in US-based hospital emergency departments during 2001 to 2004 by using the National Electronic Injury Surveillance System-All Injury Program. An estimated 26 527 (95% CI = 18 664-34 390) injuries were treated annually-78% were heat-related. People with heat-related conditions were men (P < 0.001) and had a median age of 34 years (range = <1 month-94 years). Targeting vulnerable populations in community-wide response measures may reduce injuries from adverse environmental exposures, especially heat.

Creating a nationally representative sample of patients from trauma centers.

BACKGROUND: The National Trauma Data Bank (NTDB) was developed as a convenience sample of registry data from contributing trauma centers (TCs), thus, inferences about trauma patients may not be valid at the national level. The NTDB National Sample was created to obtain nationally representative estimates of trauma patients treated in the US level I and II TCs. METHODS: Level I and II TCs in the Trauma Information Exchange Program were identified and a random stratified sample of 100 TCs was selected. The probability-proportional-to-size method was used to select TCs and sample weights were calculated. National Sample Program estimates from 2003 to 2006 were compared with raw NTDB data, and to a subset of TCs in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, a population-based dataset drawn from community hospitals. RESULTS: Weighted estimates from the NTDB National Sample range from 484,000 (2004) to 608,000 (2006) trauma incidents. Crude NTDB data over-represented the proportion of younger patients (0 years-14 years) compared with the NTDB National Sample, which does not include children's hospitals. Few TCs in Trauma Information Exchange Program are included in Healthcare Cost and Utilization Project Nationwide Inpatient Sample, but estimates based on this subset indicate a higher percentage of older patients (age 65 year or older, 23.98% versus 17.85%), lower percentage male patients, and a lower percentage of motor vehicle accidents compared with NTDB National Sample. CONCLUSION: Although nationally representative data regarding trauma patients are available in other population-based samples, they do not represent TCs patients and lack the specificity of National Sample Program data, which contains detailed information on injury mechanisms, diagnoses, and hospital treatment.