Validation of an ICD-10 coded case definition for the identification of patients diagnosed with sepsis and severe sepsis using administrative data
Date
2015-02-10
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Abstract
Background: We assessed the validity of existing ICD case definitions used to identify sepsis in administrative data and validated and optimized an existing ICD-10-CA coding algorithm to identify patients diagnosed with sepsis.
Methods: Standard systematic review methodology was applied to assess the validity of ICD case definitions for sepsis. The CIHI ICD-10-CA coding algorithm for sepsis was validated and optimized using a randomly selected cohort of ICU and non-ICU patients. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were calculated.
Results: Twelve studies were identified in the systematic review with a range of diagnostic accuracy reported indicating that sepsis is highly under-coded. We increased the accuracy of the CIHI ICD-10-CA coding algorithm for sepsis (Sn: 71.9%, NPV: 66.6%) and severe sepsis (Sn: 65.1%, NPV: 70.1%) while slightly decreasing Sp and PPV.
Conclusions: Sepsis is highly under-coded in administrative data. The new definition has a much higher sensitivity and negative predictive value.
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Epidemiology, Health Care Management, Medicine and Surgery
Citation
Jolley, R. (2015). Validation of an ICD-10 coded case definition for the identification of patients diagnosed with sepsis and severe sepsis using administrative data (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/28626