Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases
Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases
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DOI：
10.1016/j.ajem.2017.05.003
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Aks, Steven
中科院分区：
文献类型：
--
作者：
Moore, P. Quincy;Weber, Joseph;Aks, Steven
目的：描述在一个大城市地区发生意外的芬太尼暴发期间，现有的三个监测系统的监测数据。方法：我们对芝加哥消防局EMS、库克县法医和伊利诺伊州毒物中心的三个数据集进行了回顾分析。每一份都包括从2015年1月1日到2015年12月31日的数据。EMS数据包括伊利诺伊州芝加哥的所有EMS对疑似阿片类药物过量的反应，其中使用了纳洛酮，EMS人员记录了其他指示阿片类药物过量的标准。法医数据包括伊利诺伊州库克县所有与海洛因、芬太尼或两者都有关的死亡。伊利诺伊州毒药中心的数据包括伊利诺伊州芝加哥的所有电话，涉及芬太尼、海洛因和其他处方阿片类药物。使用Microsoft Excel(R)的描述性统计用于分析数据和创建数据。结果：我们发现，在2015年9月30日至10月10日的11天期间，与阿片类药物相关的EMS反应出现了高峰。法医数据显示，2015年9月和10月，芬太尼和混合芬太尼/海洛因相关死亡人数均有所增加(分别比中位数高375%和550%)。伊利诺伊州毒药中心的数据显示，2015年9月至10月期间，海洛因、芬太尼或其他阿片类药物相关电话没有显著增加。结论：我们的数据表明，EMS数据是一种有效的实时监测机制，可以监测阿片类药物过量比率的变化。法医的数据被发现对于确认EMS监测数据和识别特定的毒物是有价值的。中毒中心的数据与EMS或法医数据没有相关性。(C)2017 Elsevier Inc.保留所有权利。
Objective: Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area.& para;& para;Methods: We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel (R) were used to analyze the data and create figures.& para;& para;Results: We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10,2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015.& para;& para;Conclusion: Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. (C) 2017 Elsevier Inc. All rights reserved.