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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| Format: | Journal Article |
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Australasian Academy of Critical Care Medicine
2012
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| Online Access: | http://search.informit.com.au/fullText;dn=505558018382492;res=IELHEA http://hdl.handle.net/20.500.11937/6854 |
| _version_ | 1848745197268107264 |
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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. |
| first_indexed | 2025-11-14T06:13:32Z |
| format | Journal Article |
| id | curtin-20.500.11937-6854 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:13:32Z |
| publishDate | 2012 |
| publisher | Australasian Academy of Critical Care Medicine |
| recordtype | eprints |
| repository_type | Digital Repository |
| 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 |