Establishing Syndromic Surveillance of Acute Coronary Syndrome, Myocardial Infarction, and Stroke: Registry Study Based on Routine Data From German Emergency Departments

Abstract BackgroundEmergency department (ED) routine data offer a unique opportunity for syndromic surveillance of communicable and noncommunicable diseases (NCDs). In 2020, the Robert Koch Institute established a syndromic surveillance system using ED data from the AKTIN regi...

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Main Authors: Madlen Schranz, Mirjam Rupprecht, Annette Aigner, Leo Benning, Carmen Schlump, Nesrine Charfeddine, Michaela Diercke, Linus Grabenhenrich, Alexander Ullrich, Hannelore Neuhauser, Birga Maier, Felix Patricius Hans, Sabine Blaschke
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:JMIR Public Health and Surveillance
Online Access:https://publichealth.jmir.org/2025/1/e66218
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Summary:Abstract BackgroundEmergency department (ED) routine data offer a unique opportunity for syndromic surveillance of communicable and noncommunicable diseases (NCDs). In 2020, the Robert Koch Institute established a syndromic surveillance system using ED data from the AKTIN registry. The system provides daily insights into ED utilization for infectious diseases. Adding NCD indicators to the surveillance is of great public health importance, especially during acute events, where timely monitoring enables targeted public health responses and communication. ObjectiveThis study aimed to develop and validate syndrome definitions for the NCD indicators of acute coronary syndrome (ACS), myocardial infarction (MI), and stroke (STR). MethodsFirst, syndrome definitions were developed with clinical experts combining ED diagnosis, chief complaints, diagnostic certainty, and discharge information. Then, using the multicenter retrospective routine ED data provided by the AKTIN registry, we conducted internal validation by linking ED cases fulfilling the syndrome definition with the hospital discharge diagnoses and calculating sensitivity, specificity, and accuracy. Lastly, external validation comprised the comparison of the ED cases fulfilling the syndrome definition with the federal German hospital diagnosis statistic. Ratios comparing the relative number of cases for all syndrome definitions were calculated and stratified by age and sex. ResultsWe analyzed data from 9 EDs, totaling 704,797 attendances from January 1, 2019, to March 5, 2021. Syndrome definitions were based on ICD-10 ConclusionsWe developed NCD indicators for ACS, MI, and STR that showed high levels of internal and external validity. The integration of these indicators into the syndromic surveillance system for EDs could enable daily monitoring of NCD patterns and trends to enhance timely public health surveillance in Germany.
ISSN:2369-2960