{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T02:52:27Z","timestamp":1787107947731,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"S1","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CE003504-02-00"],"award-info":[{"award-number":["U01CE003504-02-00"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Inj. Epidemiol."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A drowning definition is available for use with National Syndromic Surveillance Program (NSSP) data. However, its accuracy in capturing drowning emergency department and urgent care visits at the regional level is unknown. We tested the ability of the syndromic surveillance (SS) definition in capturing unintentional and undetermined intent drowning (UUID) and describe UUID SS visit trends in a large metropolitan area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We applied the drowning definition to NSSP data from 2016 to 2022 for the 8-county metropolitan Houston region. We queried the dataset for UUID ICD-10-CM codes and manually reviewed the chief complaint (CC) and discharge diagnosis (DD) for SS visits. True-positives were calculated by dividing the number of UUID cases identified by UUID ICD-10-CM codes and CC\/DD review by the total visits captured by the SS definition. Demographics and trends of UUID visits were calculated from 2018 to 2022 due to limited data from 2016 to 2017 in NSSP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>2,759 visits were captured by the SS definition. After case review, 2,019 (73.2%) had ICD-10-CM drowning codes of any intent; and 2,015 of those (99.8%) were classified as UUID. Of the remaining 740 cases with no ICD-10-CM codes that were pulled by the SS definition, 690 (93.2%) had a CC\/DD diagnosis of drowning\/submersion\/underwater related to aquatic exposure. Taken together, 2,705 (98.0%) were true-positive UUID visits based on the SS drowning definition.. Children (aged\u2009&lt;\u200918\u00a0years) constituted 79% of UUID visits. Black, White and Asian\/Pacific Islander persons comprised 17%, 60% and 4% of UUID visits respectively. Rates of UUID visits were lowest in 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Syndromic surveillance is a novel and accurate method to conduct real-time drowning surveillance in a large metropolitan region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40621-024-00529-x","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T05:02:11Z","timestamp":1727326931000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Using syndromic surveillance for unintentional and undetermined intent drowning surveillance in a large metropolitan area"],"prefix":"10.1186","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7518-7223","authenticated-orcid":false,"given":"Rohit P.","family":"Shenoi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briana","family":"Moreland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Peoples","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Camp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ned","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"529_CR1","unstructured":"Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) (2023). https:\/\/www.cdc.gov\/injury\/wisqars\/index.html. Accessed on 24 July 2023"},{"key":"529_CR2","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics (2023) Multiple Cause of Death 2018\u20132021on CDC WONDER Online Database 2021 http:\/\/wonder.cdc.gov\/ucd-icd10-expanded.html. Accessed on 24 Jul 2023"},{"issue":"24","key":"529_CR3","doi-asserted-by":"publisher","first-page":"869","DOI":"10.15585\/mmwr.mm7024a1","volume":"70","author":"T Clemens","year":"2021","unstructured":"Clemens T, Moreland B, Lee R. Persistent racial\/ethnic disparities in fatal unintentional drowning rates among persons Aged \u2264 29 Years-United States, 1999\u20132019. MMWR Morb Mortal Wkly Rep. 2021;70(24):869\u201374. https:\/\/doi.org\/10.15585\/mmwr.mm7024a1.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"2","key":"529_CR4","doi-asserted-by":"publisher","first-page":"e2021052227","DOI":"10.1542\/peds.2021-052227","volume":"148","author":"SA Denny","year":"2021","unstructured":"Denny SA, Quan L, Gilchrist J, et al. Prevention of drowning. Pediatrics. 2021;148(2):e2021052227. https:\/\/doi.org\/10.1542\/peds.2021-052227.","journal-title":"Pediatrics"},{"key":"529_CR11","unstructured":"Governor Abbott Issues Executive Orders to Mitigate Spread of COVID-19 In Texas (2023). https:\/\/gov.texas.gov\/news\/post\/governor-abbott-issues-executive-orders-to-mitigate-spread-of-covid-19-in-texas. Accessed on 30 Sep 2023"},{"issue":"23","key":"529_CR5","doi-asserted-by":"publisher","first-page":"699","DOI":"10.15585\/mmwr.mm6923e1","volume":"69","author":"KP Hartnett","year":"2020","unstructured":"Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on emergency department visits-United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699\u2013704. https:\/\/doi.org\/10.15585\/mmwr.mm6923e1.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"205","key":"529_CR6","doi-asserted-by":"publisher","first-page":"105570","DOI":"10.1016\/j.ocecoaman.2021.105570","volume":"1","author":"C Houser","year":"2021","unstructured":"Houser C, Vlodarchyk B. Impact of COVID-19 on drowning patterns in the Great Lakes region of North America. Ocean Coast Manag. 2021;1(205):105570.","journal-title":"Ocean Coast Manag"},{"issue":"7","key":"529_CR7","doi-asserted-by":"publisher","first-page":"e000024","DOI":"10.1161\/HCQ.0000000000000024","volume":"10","author":"AH Idris","year":"2017","unstructured":"Idris AH, Bierens JJLM, Perkins GD, et al. 2015 revised Utstein-style recommended guidelines for uniform reporting of data from drowning-related resuscitation: an ILCOR advisory statement. Circ Cardiovasc Qual Outcomes. 2017;10(7):e000024. https:\/\/doi.org\/10.1161\/HCQ.0000000000000024.","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"4","key":"529_CR8","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1136\/ip.2008.020461","volume":"15","author":"CC Irwin","year":"2009","unstructured":"Irwin CC, Irwin RL, Ryan TD, Drayer J. Urban minority youth swimming (in)ability in the United States and associated demographic characteristics: toward a drowning prevention plan. Inj Prev. 2009;15(4):234\u20139.","journal-title":"Inj Prev"},{"key":"529_CR9","doi-asserted-by":"publisher","DOI":"10.1177\/00333549241249675","author":"B Moreland","year":"2024","unstructured":"Moreland B, Clemens T, Idaikkadar N. Syndromic surveillance of emergency department visits related to unintentional drowning, United States, 2019\u20132022. Public Health Rep. 2024. https:\/\/doi.org\/10.1177\/00333549241249675.","journal-title":"Public Health Rep"},{"issue":"6","key":"529_CR10","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.jadohealth.2022.06.026","volume":"71","author":"ER Morgan","year":"2022","unstructured":"Morgan ER, Hitchcock W, Sakamoto I, Stempski S, Rivara F, Vavilala M, Quan L. Disparities in adolescent reported drowning prevention strategies. J Adolesc Health. 2022;71(6):757\u201360.","journal-title":"J Adolesc Health"},{"key":"529_CR16","unstructured":"NSSP Update (2019) https:\/\/www.cdc.gov\/nssp\/news\/2019\/12-december\/index.html"},{"issue":"1","key":"529_CR12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3390\/sports6010017","volume":"6","author":"J Pharr","year":"2018","unstructured":"Pharr J, Irwin C, Layne T, Irwin R. Predictors of swimming ability among children and adolescents in the United States. Sports (Basel). 2018;6(1):17.","journal-title":"Sports (Basel)"},{"key":"529_CR13","doi-asserted-by":"publisher","first-page":"109788","DOI":"10.1016\/j.resuscitation.2023.109788","volume":"187","author":"K Ryan","year":"2023","unstructured":"Ryan K, Bui MD, Johnson B, et al. Drowning in the United States: patient and scene characteristics using the novel CARES drowning variables. Resuscitation. 2023;187:109788. https:\/\/doi.org\/10.1016\/j.resuscitation.2023.109788.","journal-title":"Resuscitation"},{"key":"529_CR14","unstructured":"The National Syndromic Surveillance Program (NSSP) (2024) https:\/\/www.cdc.gov\/nssp\/php\/about\/index.html. Accessed on 12 June 2024"},{"key":"529_CR17","unstructured":"US census (2023). https:\/\/www.census.gov\/data.html. Accessed on 18 June 2023"},{"issue":"11","key":"529_CR18","first-page":"853","volume":"83","author":"EF van Beeck","year":"2005","unstructured":"van Beeck EF, Branche CM, Szpilman D, et al. A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ. 2005;83(11):853\u20136.","journal-title":"Bull World Health Organ"},{"key":"529_CR19","unstructured":"Xu J (2014) Unintentional drowning deaths in the United States, 1999\u20132010. NCHS data brief, no 149. Hyattsville, MD: National Center for Health Statistics. https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db149.htm"},{"issue":"1 Suppl","key":"529_CR20","doi-asserted-by":"publisher","first-page":"3S","DOI":"10.1177\/0033354917708995","volume":"132","author":"PW Yoon","year":"2017","unstructured":"Yoon PW, Ising AI, Gunn JE. Using syndromic surveillance for all-hazards public health surveillance: successes, challenges, and the future. 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