Assessing hospital treatment for alcohol-related injury in Minnesota using 2000 - 2015 hospital discharge data: Opportunities and challenges.

OBJECTIVE: Excessive alcohol use, especially binge drinking, is an important risk factor for unintentional and intentional injuries. This study used hospital discharge data (HDD) to estimate the prevalence and trends of treatments for alcohol-related injury (ARI) in Minnesota, and discussed opportunities and challenges for public health surveillance. METHOD: We examined hospital-treated ARI in Minnesota between 2000 and 2015 using HDD (age ≥12 years). ARI was defined as hospital discharges with an injury diagnosis and a diagnosis related to alcohol in any diagnosis field. RESULTS: The number of hospital-treated injuries increased by 30 % between 2000 and 2015. The number of those injuries that were alcohol-related increased by 166 % from 2000 to 2015. ARI were more likely to be treated as inpatients than all injuries-in 2015, 34 % of ARI were inpatient, compared to 17 % of all injuries. Patients treated for ARI were more likely to be male and older than the average injury patient. In 2015, ARI were more likely than all injuries to be self-inflicted (11.6 % vs. 1.9 %), related to assault (14.4 % vs. 3.6 %), and less likely to be unintentional (63.8 % vs. 78.5 %). CONCLUSIONS: These analyses suggest that the rate of hospital-treated ARI increased more steeply from 2000 to 2015 than all injuries. While there are significant challenges to using HDD for surveillance, further work to assess the validity of the data source is warranted.

This is your brain on sports. Measuring concussions in high school athletes in the Twin Cities metropolitan area.

Concussions can have a negative impact on students' ability to perform in the classroom as well as on their health and well-being. Therefore, timely treatment is especially important. To better understand the scope of the problem in Minnesota, the Minnesota Department of Health piloted an online sports-related concussion reporting system in 36 public high schools in the Twin Cities metropolitan area. In the 2013-2014 academic year, 730 concussions were reported to our system from certified athletic trainers working with those schools, with one out of every 100 athletes sustaining concussions. From this, we estimated that 2,974 sports-related concussions occurred among high school athletes statewide. This information is useful for evaluating and guiding prevention efforts and for informing clinicians on how to treat concussions.

The high cost of bath salts: a study of the health care burden of illicit synthetic drug use in Duluth, Minnesota.

The Minnesota Department of Health conducted an exploratory epidemiologic investigation into the health care burden of illicit synthetic drug (ISD) use in Duluth, Minnesota. Staff reviewed medical records of 78 patients with suspected ISD use who were treated in emergency departments at two Duluth-area hospitals from January through September 2013. Most (67%) were unemployed, 75% arrived at the hospital by ambulance or police escort and 57% were admitted to the hospital. Use of ISDs has the potential to create a significant burden on the health care system and public services. Therefore, effective prevention and response strategies need to be developed.

Nonfatal work-related traumatic brain injury in Minnesota, 1999-2008.

The Centers for Disease Control and Prevention has identified traumatic brain injury (TBI) as a public health problem in the United States; it is notable that some variables of work-related TBI are different from those of non-work-related TBI. The Minnesota Department of Health has been conducting epidemiologic surveillance of cases of hospitalized TBI since 1993. Although most of the surveillance efforts have focused on all TBIs, the department does collect data on work-related TBIs and their associated outcomes. This article summarizes trends for nonfatal, work-related TBI cases over person, place, and time in Minnesota from 1999 to 2008. The greatest proportion of cases involved persons 35 to 44 years of age, and the most common causes were falls, motor vehicle traffic crashes, and being struck by objects. Most injuries occurred in the home, a location not routinely subjected to oversight for occupational safety concerns. The work-related TBI rate has been decreasing since 2004. This article also discusses the role of the physician in identifying and treating TBI.

Nonfatal suicide attempts and other self-inflicted harm. Beltrami County youths, 2002-2006.

Following a highly publicized murder-suicide by a high school student in Beltrami County, Minnesota, the Minnesota Department of Health initiated an investigation into suicide attempts and self-inflicted harm (SA/SIH) among youths in the county between 2002 and 2006. This article summarizes the results of that effort, which found an annualized rate of 356 hospital-treated SA/SIH per 100,000 population among Beltrami County residents ages 10 to 24 years--a rate more than 50% higher than that of other youths in Minnesota or the United States. In addition, the rate of SA/SIH for American Indian youths in Beltrami County was 2.5 times higher than that for white youths. An examination of medical history found 52% of the youths in this study had previously attempted suicide. This article also discusses several modifiable risk factors that were identified and potential interventions.

Connecting kids! Effective recruitment for resource facilitation in the pediatric population.

OBJECTIVE: To describe and compare recruitment strategies to Resource Facilitation (RF) for children and youth with an incident traumatic brain injury. POPULATION: The universe of Minnesota children (0-14 years old) and youth (15-24 years old) with a traumatic brain injury, and discharge date in the year 2005. METHODS: Using an observational study design, registry data were merged with the data sets kept for each method of contact. RESULTS: A total of 96% of this population had some form of contact; 12% participated in RF. With each added contact, participation consistently increased. CONCLUSION: Resource Facilitation recruitment needs to rely on multiple methods and multiple contacts to achieve the highest participation.

Hospital-treated dog bites in Minnesota, 1998-2005.

This paper is the first to describe the incidence of hospital-treated dog bites in Minnesota using hospital discharge data supplemented with medical record review. The rate of hospital-treated dog bites rose 40% during the 8-year period studied, with the largest growth being seen in the number of emergency department (ED) visits. The highest rates of both hospitalization and ED treatment occurred among children ages 1 to 4 years. In most instances (75%), the victim was familiar with the dog(s) involved. The dog bites most often occurred in the home (48%) and yard (18%). Our findings emphasize the importance of physicians, especially pediatricians and family physicians, counseling parents about the importance of supervising their children when they are around dogs and teaching them safe behaviors around animals. Finally, this study validates the value of hospital discharge data for surveillance of hospital-treated dog bites.

Epidemiology of emergency department-treated traumatic brain injury in Minnesota.

A number of population-based studies have been published on mortality and hospitalizations associated with traumatic brain injury (TBI). However, very little has been published on treatment of TBI in the emergency department (ED), despite the fact that most cases are seen in such settings. Minnesota is 1 of 2 states funded by the Centers for Disease Control and Prevention since 2001 to conduct surveillance of TBIs treated in EDs. A sample of medical records from 2002 and 2003 was reviewed to better understand the epidemiology of ED-treated TBI and identify risk factors for and interventions to prevent them. We found males, infants, adolescents and young adults, blacks, and residents of the 7-county Twin Cities metropolitan area were most likely to be seen in the ED for TBI. Sports and recreational activities were the leading causes of these injuries, followed by falls and motor vehicle crashes.

Epidemiology of trauma in Minnesota.

Injury accounts for more than 2,500 deaths and 300,000 hospital admissions in Minnesota each year. Using the 2002 Minnesota hospital discharge database, we examined the subset of hospital-treated injuries that received trauma care and categorized claims into trauma-related deaths, cases of nonfatal major trauma, and other cases that received specialized trauma care. We also examined where trauma patients received their care, the leading diagnoses for trauma deaths and nonfatal major trauma, and whether a statewide trauma system that would identify and equip more hospitals as trauma centers would have significant potential for improving trauma care in Minnesota.