ArticleAnnals of the American Thoracic Society2016
Identifying Vasopressor and Inotrope Use for Health Services Research.
Article in Annals of the American Thoracic Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Development of a machine-learning risk stratification tool for vasoactive medication need after two-bolus fluid resuscitation in pediatric suspected sepsis.Pediatric research · 2026Article
- Epidemiology and outcomes of septic shock in Japan: a nationwide retrospective cohort study from a medical claims database by the Japan Sepsis Alliance (JaSA) study group.Critical care (London, England) · 2025Article
- External validation of the hospital frailty risk score among older adults receiving mechanical ventilation.Scientific reports · 2022Article
- Trends and outcomes of mechanically ventilated cirrhotic patients in the United States from 2005-2014.Journal of the Intensive Care Society · 2022Article
- Validation of the V49.86 Code for Do-Not-Resuscitate Status in Hospitalized Patients at a Single Academic Medical Center.Annals of the American Thoracic Society · 2018Article
- Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center.Journal of palliative medicine · 2017Article
- Epidemiology of Vasopressin Use for Adults with Septic Shock.Annals of the American Thoracic Society · 2016Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
rationaleIdentifying vasopressor and inotrope (vasopressor) use from administrative claims data may provide an important resource to study the epidemiology of shock.
objectivesDetermine accuracy of identifying vasopressor use using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) coding.
methodsUsing administrative data enriched with pharmacy billing files (Premier, Inc., Charlotte, NC), we identified two cohorts: adult patients admitted with a diagnosis of sepsis from 2010 to 2013 or pulmonary embolism (PE) from 2008 to 2011. Vasopressor administration was obtained using pharmacy billing files (dopamine, dobutamine, epinephrine, milrinone, norepinephrine, phenylephrine, vasopressin) and compared with ICD-9-CM procedure code for vasopressor administration (00.17). We estimated performance characteristics of the ICD-9-CM code and compared patients' characteristics and mortality rates according to vasopressor identification method. MEASUREMENTS AND MAIN
resultsUsing either pharmacy data or the ICD-9-CM procedure code, 29% of 541,144 patients in the sepsis cohort and 5% of 81,588 patients in the PE cohort were identified as receiving a vasopressor. In the sepsis cohort, the ICD-9-CM procedure code had low sensitivity (9.4%; 95% confidence interval, 9.2-9.5), which increased over time. Results were similar in the PE cohort (sensitivity, 5.8%; 95% confidence interval, 5.1-6.6). The ICD-9-CM code exhibited high specificity in the sepsis (99.8%) and PE (100%) cohorts. However, patients identified as receiving vasopressors by ICD-9-CM code had significantly higher unadjusted in-hospital mortality, had more acute organ failures, and were more likely hospitalized in the Northeast and West.
conclusionsThe ICD-9-CM procedure code for vasopressor administration has low sensitivity and selects for higher severity of illness in studies of shock. Temporal changes in sensitivity would likely make longitudinal shock surveillance using ICD-9-CM inaccurate.
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