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Surveillance of concussion-related injuries using electronic medical records from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN): a proof-of-concept

  • Felix Bang
  • Behrouz Ehsani
  • Steven McFaullEmail author
  • Vicky C. Chang
  • John Queenan
  • Richard Birtwhistle
  • Minh T. Do
Quantitative Research
First Online:

Abstract

Introduction

Previous studies on traumatic brain injury trends in Canada have been restricted to hospitalization and emergency department visit data. However, many concussion patients may present first, or only, to family physicians. Therefore, the true burden of concussion in Canada is likely underestimated. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) collects information electronically from family physicians across Canada and can potentially be used for concussion surveillance. The objective of this study is to explore the feasibility of using data collated from CPCSSN for concussion surveillance purposes and examine trends over time.

Methods

Electronic medical records housed by CPCSSN from 2010 to 2016 were analyzed. Case ascertainment was determined through a combination of International Classification of Diseases, Ninth Revision codes. Binomial regression models were used to calculate the prevalence ratio (PR) of concussion by age, sex, deprivation indices, body mass index, and comorbid conditions.

Results

Concussion prevalence rates increased from 2010 to 2016 (p < 0.001). Based on 2016 data, males had a higher prevalence of concussion compared with females (PR = 1.09; 95% CI 1.02, 1.18), and those aged 10–14 (PR = 8.52; 95% confidence interval [CI] 6.34, 11.44) and 15–19 (PR = 7.75; 95% CI 5.84, 10.28) had higher prevalence of concussion compared with those aged 0–4 years.

Conclusion

This pilot study demonstrates the feasibility of using the CPCSSN system for surveillance of concussion in the Canadian population. The initial findings on prevalence are in agreement with previous studies that have used hospitalization or emergency department data.

Keywords

Concussion Mild traumatic brain injury Injury Electronic medical records ICD coding classification Surveillance 

Résumé

Objectifs

Les études menées précédemment sur les tendances relatives aux traumatismes crâniens au Canada se limitent aux données sur les hospitalisations et les visites aux services des urgences. Or, dans de nombreux cas, les patients victimes d’une commotion cérébrale consultent d’abord (ou uniquement) leur médecin de famille. Par conséquent, le fardeau réel des commotions cérébrales au Canada est probablement sous-estimé. Le Réseau canadien de surveillance sentinelle en soins primaires (RCSSSP), qui recueille par voie électronique des données auprès des médecins de famille de partout au Canada, pourrait servir à assurer la surveillance des commotions cérébrales. La présente étude vise à évaluer la faisabilité de l’utilisation des données issues du RCSSSP aux fins de la surveillance des commotions cérébrales et à examiner les tendances au fil du temps.

Méthodes

Nous avons analysé les dossiers médicaux électroniques de 2010 à 2016 conservés par le RCSSSP. Pour les besoins de la détermination des cas, nous avons eu recours à une combinaison de codes de la Classification internationale des maladies, neuvième révision (CIM-9). Nous avons utilisé des modèles de régression binomiale pour calculer le taux de prévalence (TP) des commotions cérébrales selon l’âge, le sexe, les indices de défavorisation, l’indice de masse corporelle et la comorbidité.

Résultats

Les taux de prévalence des commotions cérébrales ont augmenté de 2010 à 2016 (p < 0,001). Selon les données de 2016, la prévalence des commotions cérébrales était plus élevée chez les hommes que chez les femmes (TP = 1,09; intervalle de confiance [IC] à 95 % : 1,02 à 1,18); de même, les groupes des 10 à 14 ans (TP = 8,52; IC à 95 % : 6,34 à 11,44) et des 15 à 19 ans (TP = 7,75; IC à 95 % : 5,84 à 10,28) présentaient des taux de prévalence des commotions cérébrales plus élevés que le groupe des 0 à 4 ans.

Conclusion

La présente étude pilote démontre la faisabilité de l’utilisation du système du RCSSSP aux fins de la surveillance des commotions cérébrales dans la population canadienne. Les résultats initiaux sur le plan de la prévalence concordent avec les résultats des études antérieures fondées sur les données relatives aux hospitalisations ou aux visites aux services des urgences.

Mots-clés

Commotion cérébrale Traumatisme crânien léger Blessure Dossiers médicaux électroniques Classification et codage de la CIM Surveillance 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  • Felix Bang
    • 1
    • 2
  • Behrouz Ehsani
    • 3
  • Steven McFaull
    • 2
    Email author
  • Vicky C. Chang
    • 1
  • John Queenan
    • 3
  • Richard Birtwhistle
    • 3
  • Minh T. Do
    • 1
    • 2
    • 4
  1. 1.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  2. 2.Centre for Surveillance and Applied Research, Injury and Healthy Living UnitPublic Health Agency of CanadaOttawaCanada
  3. 3.Department of Family MedicineQueen’s UniversityKingstonCanada
  4. 4.Department of Health SciencesCarleton UniversityOttawaCanada

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