In 2017, 951 Missouri residents died from an opioid overdose, a record number for the state.1 This continues the trend from 2016, which saw an increase of over 30% in opioid overdose deaths compared to 2015. The Missouri Department of Health and Senior Services (MDHSS) manages several public health surveillance data sources that can be used to inform about the opioid epidemic. Opioid overdose deaths are identified through death certificates which are collected through the vital records system. MDHSS also manages the Patient Abstract System (PAS), which contains ED and inpatient hospitalization data from approximately 132 non-federal Missouri hospitals. PAS contains about 130 variables, which include demographic data, diagnoses codes, procedures codes, and other visit information. Records can have up to 23 diagnosis fields, which are coded using ICD-10-CM (International Classification of Diseases, Clinically Modified). The first diagnosis field is the primary reason for a visit.

Objective: Link emergency department (ED) with death certificate mortality data in order to examine the prior medical history of opioid overdose victims leading up to their death.