Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Liu SJ[original query] |
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Development of a definition to identify severe opioid overdoses treated in emergency departments, 2019-2022
Liu SJ , Smith H , Krishnasamy V , Gladden RM . J Public Health Manag Pract 2024 BACKGROUND: Existing surveillance systems monitor nonfatal and fatal opioid overdoses but do not monitor severe nonfatal overdoses that require intensive medical interventions. METHODS: The Centers for Disease Control and Prevention's Drug Overdose Surveillance and Epidemiology system was used to query emergency department data from local syndromic systems and the National Syndromic Surveillance Program from January 2019 to August 2022. Opioid overdoses were classified as not severe or severe using a definition from the patient's chief complaint terms and discharge diagnosis codes. The percentage of opioid overdoses treated in emergency departments classified as severe was described by patient demographics, US Census region, and month. RESULTS: Among 503 156 opioid overdoses in 29 states and Washington, DC, from January 2019 to August 2022, 17.4% were classified as severe. Common key terms found among severe opioid overdoses were hypoxia (34.8%), unresponsive (32.9%), and naloxone/Narcan (20.9%). The largest severity percentage was in the South Census region (19.6%). The trends of severe opioid overdoses remained stable during the study period. DISCUSSION: Based on the severe opioid overdose definition, there was minimal change in the severity of opioid overdoses during the study period. This definition can help monitor trends of severe opioid overdoses, guiding public health action such as focusing on naloxone and fentanyl test strip distribution to areas of need. |
Adverse childhood experiences and overdose: Lessons from overdose data to action
Wisdom AC , Govindu M , Liu SJ , Meyers CM , Mellerson JL , Gervin DW , DePadilla L , Holland KM . Am J Prev Med 2022 62 S40-s46 INTRODUCTION: Adverse childhood experiences and overdose are linked in a cycle that affects individuals and communities across generations. The Centers for Disease Control and Prevention's Overdose Data to Action cooperative agreement supports a comprehensive public health approach to overdose prevention and response activities across the U.S. Exposure to traumatic events during childhood can increase the risk for myriad health outcomes, including overdose; therefore, many Overdose Data to Action recipients leveraged funds to address adverse childhood experiences. METHODS: In 2021, an inventory of Overdose Data to Actionfunded activities implemented in 2019 and 2020 showed that 34 of the 66 recipients proposed overdose prevention activities that support people who have experienced adverse childhood experiences or that focus on preventing the intergenerational transmission of adverse childhood experiences. Activities were coded by adverse childhood experience prevention strategy, level of the social ecology, and whether they focused on neonatal abstinence syndrome. RESULTS: Most activities among Overdose Data to Action recipients occurred at the community level of the socialecologic model and under the intervene to lessen harms adverse childhood experience prevention strategy. Of the 84 adverse childhood experiencerelated activities taking place across 34 jurisdictions, 44 are focused on neonatal abstinence syndrome. CONCLUSIONS: Study results highlight the opportunities to expand the breadth of adverse childhood experience prevention strategies across the social ecology. Implementing cross-cutting overdose and adverse childhood experiencerelated activities that span the socialecologic model are critical for population-level change and have the potential for the broadest impact. Focusing on neonatal abstinence syndrome also offers a unique intervention opportunity for both adverse childhood experience and overdose prevention. |
Deaths associated with hepatitis C virus infection among residents in 50 states and the District of Columbia, 2016-2017
Ly KN , Minino AM , Liu SJ , Roberts H , Hughes EM , Ward JW , Jiles RB . Clin Infect Dis 2019 71 (5) 1149-1160 BACKGROUND: Hepatitis C virus (HCV)-associated mortality is well-documented nationally, but examination across regions and jurisdictions may inform healthcare planning. METHODS: To document HCV-associated deaths sub-nationally, we calculated age-adjusted HCV-associated death rates, compared death rate ratios (DRR) for ten US regions, 50 states, and District of Columbia (DC) with the national rate and described rate changes between 2016 and 2017 to determine variability. We examined mean age at HCV-associated death and rates and proportions by sex, race/ethnicity, and birth year. RESULTS: In 2017, there were 17,253 HCV-associated deaths, representing 4.13 (95% CI, 4.07-4.20) deaths/100,000 standard population, a significant 6.56% rate decline from 4.42 in 2016. Age-adjusted death rates significantly surpassed the US rate for the following jurisdictions: Oklahoma, DC, Oregon, New Mexico, Louisiana, Texas, Colorado, California, Kentucky, Tennessee, Arizona, and Washington (DRR, 2.87, 2.77, 2.24, 1.62, 1.57, 1.46, 1.36, 1.35, 1.35, 1.35, 1.32, 1.32, respectively) (P<0.05). Death rates ranged from a low of 1.60 (95% CI, 1.07-2.29) in Maine to a high of 11.84 (95% CI, 10.82-12.85) in Oklahoma. Death rates were highest among non-Hispanic American Indians/Alaska Natives and non-Hispanic blacks nationally and regionally. Mean age at death was 61.4 years (range, 56.6 years in West Virginia to 64.1 years in DC); 78.6% of deaths were born during 1945-1965. CONCLUSION: In 2016-2017, national HCV-associated mortality declined but remained high in western and southern regions, DC, non-Hispanic American Indians/Alaska Natives, non-Hispanic blacks, and Baby Boomers. These data can inform local prevention and control programs to reduce the HCV mortality burden. |
Patient awareness of need for hepatitis A vaccination (prophylaxis) before international travel
Liu SJ , Sharapov U , Klevens M . J Travel Med 2015 22 (3) 174-8 INTRODUCTION: Although hepatitis A virus (HAV) infection is preventable through vaccination, cases associated with international travel continue to occur. The purpose of this study was to examine the frequency of international travel and countries visited among persons infected with HAV and assess reasons why travelers had not received hepatitis A vaccine before traveling. METHODS: Using data from sentinel surveillance for HAV infection in seven US counties during 1996 to 2006, we examined the role of international travel in hepatitis A incidence and the reasons for patients not being vaccinated. RESULTS: Of 2,002 hepatitis A patients for whom travel history was available, 300 (15%) reported traveling outside of the United States. Compared to non-travelers, travelers were more likely to be female [odds ratio (OR) = 1.74 (95% confidence interval [95% CI], 1.35, 2.24)], aged 0 to 17 years [OR = 3.30 (1.83, 5.94)], Hispanic [OR = 3.69 (2.81, 4.86)], Asian [OR = 2.00 (1.06, 3.77)], and were less likely to be black non-Hispanic [OR = 0.30 (0.11, 0.82)]. The majority, 189 (61.6%), had traveled to Mexico. The most common reason for not getting pre-travel vaccination was "Didn't know I could [or should] get shots" [100/154 (65%)]. CONCLUSION: Low awareness of HAV vaccination was the predominant reason for not being protected before travel. Different modes of traveler education could improve prevention of hepatitis A. To highlight the risk of infection before traveling to endemic countries including Mexico, travel and consulate websites could list reminders of vaccine recommendations. |
Characterization of chronic hepatitis B cases among foreign-born persons in six population-based surveillance sites, United States 2001-2010
Liu SJ , Iqbal K , Shallow S , Speers S , Rizzo E , Gerard K , Poissant T , Klevens RM . J Immigr Minor Health 2014 17 (1) 7-12 National surveys indicate prevalence of chronic hepatitis B among foreign-born persons in the USA is 5.6 times higher than US-born. Centers for Disease Control and Prevention funded chronic hepatitis B surveillance in Emerging Infections Program sites. A case was any chronic hepatitis B case reported to participating sites from 2001 to 2010. Sites collected standardized demographic data on all cases. We tested differences between foreign- and US-born cases by age, sex, and pregnancy using Chi square tests. We examined trends by birth country during 2005-2010. Of 36,008 cases, 21,355 (59.3 %) reported birth in a country outside the USA, 2,323 (6.5 %) were US-born. Compared with US-born, foreign-born persons were 9.2 times more frequent among chronic hepatitis B cases. Foreign-born were more frequently female, younger, ever pregnant, and born in China. Percentages of cases among foreign-born persons were constant during 2005-2010. Our findings support information from US surveillance for Hepatitis B screening and vaccination efforts. |
Mortality among persons in care with hepatitis C virus infection - the Chronic Hepatitis Cohort Study (CHeCS), 2006-2010
Mahajan R , Xing J , Liu SJ , Ly KN , Moorman AC , Rupp L , Xu F , Holmberg SD . Clin Infect Dis 2014 58 (8) 1055-61 BACKGROUND: Numbers of deaths in hepatitis C virus (HCV)-infected persons recorded on US death certificates have been increasing, but actual rates and causes of death in them have not been well elucidated. METHODS: Disease-specific, liver- and non-liver-related, mortality for HCV-infected patients in an observational cohort study, the Chronic Hepatitis Cohort Study (CHeCS) at four US health care systems, were compared with Multiple Cause of Death (MCOD) data in 12 million death certificates in 2006-2010. Pre-mortem diagnoses, liver biopsies, and FIB-4 scores (a non-invasive measure of liver damage) were examined. RESULTS: Of 2,143,369 adult patients seen at CHeCS sites in 2006-2010, 11,703 (0.5%) had diagnosed chronic HCV infection, and 1,590 (14%) died. CHeCS decedents were born from 1945-1965 (75%), white (50%), and male (68%); mean age of death was 59 years, 15 years younger than MCOD deaths. The age-adjusted mortality rate for liver disease in CHeCS was twelve times higher than the MCOD rate. Before death, 63% had medical record evidence of chronic liver disease, 76% had elevated FIB-4 scores, and of those biopsied 70% had moderate or worse liver fibrosis. However, only 19% of all CHeCS decedents and only 30% of those with recorded liver disease had HCV listed on their death certificates. CONCLUSIONS: HCV infection is greatly under-documented on death certificates. The 16,622 persons with HCV listed in 2010 may represent only one-fifth of about 80,000 HCV-infected persons dying that year, at least two-thirds of whom (53,000 patients) would have pre-mortem indications of chronic liver disease. |
Indications for testing among reported cases of HCV infection from enhanced hepatitis surveillance sites in the United States, 2004-2010
Mahajan R , Liu SJ , Klevens RM , Holmberg SD . Am J Public Health 2013 103 (8) 1445-9 OBJECTIVES: Centers for Disease Control and Prevention has recommended a 1-time HCV test for persons born from 1945 through 1965 to supplement current risk-based screening. We examined indications for testing by birth cohort (before 1945, 1945-1965, and after 1965) among persons with past or current HCV. METHODS: Cases had positive HCV laboratory markers reported by 4 surveillance sites (Colorado, Connecticut, Minnesota, and New York) to health departments from 2004 to 2010. Health department staff abstracted demographics and indications for testing from cases' medical records and compiled this information into a surveillance database. RESULTS: Of 110 223 cases of past or current HCV infection reported during 2004-2010, 74 578 (68%) were among persons born during 1945-1965. Testing indications were abstracted for 45 034 (41%) cases; of these, 29 544 (66%) identified at least 1 Centers for Disease Control and Prevention-recommended risk factor as a testing indication. Overall, 74% of reported cases were born from 1945 to 1965 or had an injection drug use history. CONCLUSIONS: These data support augmenting the current HCV risk-based screening recommendations by screening adults born from 1945 to 1965. |
Use of the International Classification of Diseases, 9th revision, coding in identifying chronic hepatitis B virus infection in health system data: implications for national surveillance
Mahajan R , Moorman AC , Liu SJ , Rupp L , Klevens RM . J Am Med Inform Assoc 2013 20 (3) 441-5 OBJECTIVE: With increasing use electronic health records (EHR) in the USA, we looked at the predictive values of the International Classification of Diseases, 9th revision (ICD-9) coding system for surveillance of chronic hepatitis B virus (HBV) infection. MATERIALS AND METHODS: The chronic HBV cohort from the Chronic Hepatitis Cohort Study was created based on electronic health records (EHR) of adult patients who accessed services from 2006 to 2008 from four healthcare systems in the USA. Using the gold standard of abstractor review to confirm HBV cases, we calculated the sensitivity, specificity, positive and negative predictive values using one qualifying ICD-9 code versus using two qualifying ICD-9 codes separated by 6 months or greater. RESULTS: Of 1,652,055 adult patients, 2202 (0.1%) were confirmed as having chronic HBV. Use of one ICD-9 code had a sensitivity of 83.9%, positive predictive value of 61.0%, and specificity and negative predictive values greater than 99%. Use of two hepatitis B-specific ICD-9 codes resulted in a sensitivity of 58.4% and a positive predictive value of 89.9%. DISCUSSION: Use of one or two hepatitis B ICD-9 codes can identify cases with chronic HBV infection with varying sensitivity and positive predictive values. CONCLUSIONS: As the USA increases the use of EHR, surveillance using ICD-9 codes may be reliable to determine the burden of chronic HBV infection and would be useful to improve reporting by state and local health departments. |
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