Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department

Objective: To determine the accuracy of International classification of diseases, 10th revision, Australian modification (ICD-10-AM) codes in identifying severe sepsis in patients admitted from the emergency department (ED). Design, setting and participants: A retrospective cohort study of ED patien...

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Main Authors: Ibrahim, I., Jacobs, Ian, Web, S., Finn, Judith
Format: Journal Article
Published: Australasian Academy of Critical Care Medicine 2012
Online Access:http://search.informit.com.au/fullText;dn=505558018382492;res=IELHEA
http://hdl.handle.net/20.500.11937/6854
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author Ibrahim, I.
Jacobs, Ian
Web, S.
Finn, Judith
author_facet Ibrahim, I.
Jacobs, Ian
Web, S.
Finn, Judith
author_sort Ibrahim, I.
building Curtin Institutional Repository
collection Online Access
description Objective: To determine the accuracy of International classification of diseases, 10th revision, Australian modification (ICD-10-AM) codes in identifying severe sepsis in patients admitted from the emergency department (ED). Design, setting and participants: A retrospective cohort study of ED patients transferred to the intensive care unit of a tertiary hospital within 24 hours of leaving ED, 2000- 2006. Main outcome measures: Clinical diagnosis of severe sepsis compared with diagnosis-based code (DB-C) categories based on ICD-10-AM codes in the Emergency Department Information Systems (EDIS) and Hospital Morbidity Data System (HMDS); sensitivity, specificity, positive predictive value (PPV) and negative predictive value of these databases. Results: In the study period, 1645 patients were transferred to the ICU from the ED, of whom 254 had severe sepsis. Single discharge ICD-10-AM codes recorded in the EDIS and the principal ICD-10-AM codes recorded in the HMDS that fell into D-BC categories for sepsis, pneumonia, viscous perforation, peritonitis, cholecystitis or cholangitis had a PPV of 85.0% (95% CI, 78.4%-91.6%; 96/113) and 88.2% (95%CI, 72.6%-82.6%; 112/127), respectively. The respective sensitivity was 37.8% (95% CI, 31.8%-43.8%) (96/254) and 44.1% (95% CI, 38.0-50.2) (112/254). In contrast, ICD-10-AM codes in the HMDS that code for infection and organ dysfunction had a PPV of 33.5% (95% CI, 30.0%-37.0%; 227/677) and sensitivity of 89.4% (95% CI, 85.6%-93.2%; 227/254). Conclusion: ICD-10-AM codes recorded in the EDIS or HMD had limited utility for identifying severe sepsis in patients admitted to ICU from the ED.
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spelling curtin-20.500.11937-68542017-10-02T02:27:19Z Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department Ibrahim, I. Jacobs, Ian Web, S. Finn, Judith Objective: To determine the accuracy of International classification of diseases, 10th revision, Australian modification (ICD-10-AM) codes in identifying severe sepsis in patients admitted from the emergency department (ED). Design, setting and participants: A retrospective cohort study of ED patients transferred to the intensive care unit of a tertiary hospital within 24 hours of leaving ED, 2000- 2006. Main outcome measures: Clinical diagnosis of severe sepsis compared with diagnosis-based code (DB-C) categories based on ICD-10-AM codes in the Emergency Department Information Systems (EDIS) and Hospital Morbidity Data System (HMDS); sensitivity, specificity, positive predictive value (PPV) and negative predictive value of these databases. Results: In the study period, 1645 patients were transferred to the ICU from the ED, of whom 254 had severe sepsis. Single discharge ICD-10-AM codes recorded in the EDIS and the principal ICD-10-AM codes recorded in the HMDS that fell into D-BC categories for sepsis, pneumonia, viscous perforation, peritonitis, cholecystitis or cholangitis had a PPV of 85.0% (95% CI, 78.4%-91.6%; 96/113) and 88.2% (95%CI, 72.6%-82.6%; 112/127), respectively. The respective sensitivity was 37.8% (95% CI, 31.8%-43.8%) (96/254) and 44.1% (95% CI, 38.0-50.2) (112/254). In contrast, ICD-10-AM codes in the HMDS that code for infection and organ dysfunction had a PPV of 33.5% (95% CI, 30.0%-37.0%; 227/677) and sensitivity of 89.4% (95% CI, 85.6%-93.2%; 227/254). Conclusion: ICD-10-AM codes recorded in the EDIS or HMD had limited utility for identifying severe sepsis in patients admitted to ICU from the ED. 2012 Journal Article http://hdl.handle.net/20.500.11937/6854 http://search.informit.com.au/fullText;dn=505558018382492;res=IELHEA Australasian Academy of Critical Care Medicine restricted
spellingShingle Ibrahim, I.
Jacobs, Ian
Web, S.
Finn, Judith
Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title_full Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title_fullStr Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title_full_unstemmed Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title_short Accuracy of International classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
title_sort accuracy of international classification of diseases, 10th revision codes for identifying severe sepsis in patients admitted from the emergency department
url http://search.informit.com.au/fullText;dn=505558018382492;res=IELHEA
http://hdl.handle.net/20.500.11937/6854