ArticleBMJ open2015
Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
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Who cites it
87 citing papers in PubMed, 1 synthesis or guideline pooled it, 149 citations in OpenAlex.
- Pooled it
- Steatotic liver disease subtypes and risk of hospitalization for sepsis: a nationwide cohort study.Annals of medicine · 2026Article
- Severity of Chronic Kidney Disease and Outcomes After Admission to the Intensive Care Unit.JAMA network open · 2026Article
- Improving retrospective ARDS case-finding using a simple 72-h physiologic persistence rule.Intensive care medicine experimental · 2026Article
- Health outcomes according to severity of acute kidney injury at ICU admission: a population-based cohort study.Intensive care medicine · 2026Article
- Novel method for trend change detection and hypothesis generation in hemovigilance: A transfusion-related immunomodulation and blood production changes study.Transfusion · 2026Article
- The Global Impact of Sepsis: Epidemiology, Recognition, Management, and Health System Challenges.Epidemiologia (Basel, Switzerland) · 2026Review
- Think sepsis, write sepsis, code sepsis - patient characteristics associated with sepsis (under-)coding in administrative health data.Infection · 2026Article
- Leveraging electronic health record data for precision medicine insights: the precision medicine registry at NYU Langone Health.npj health systems · 2026Article
- Association Between Sodium-Glucose Cotransporter-2 Inhibitors and Sepsis Risk in Patients With Type 2 Diabetes Mellitus.Journal of diabetes research · 2026Article
- Article
- Comparing outcomes of ureteric stent versus nephrostomy tube in urosepsis: a population-based study in Ontario, Canada.World journal of urology · 2025Article
- Prior Use of Renin-Angiotensin System Inhibitors and Risk of Renal Replacement Therapy in Critically Ill Elderly Patients With Sepsis: A Population-Based Cohort Study.Critical care explorations · 2025Article
- Documentation of Updated Diagnosis for Critically Ill Patients: Needs a Systematic Approach.Journal of acute medicine · 2025Article
- Long-term cardiovascular outcomes and risk factors in adult sepsis survivors: a systematic review and meta-analysis.World journal of emergency medicine · 2025Review
- Nanoporous Gold Nanoparticles-Modified Electrode for the Detection of Endotoxins.Micromachines · 2025Article
- Accuracy of the modified Global Burden of Disease International Classification of Diseases coding methods for identifying sepsis: a prospective multicentre cohort study.Critical care (London, England) · 2025Observational
- Determinants of time to positivity in bloodstream infections: an analysis of a population-based cohort in Queensland, Australia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Utilizing large language models for detecting hospital-acquired conditions: an empirical study on pulmonary embolism.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Harbingers of sepsis misdiagnosis among pediatric emergency department patients.Diagnosis (Berlin, Germany) · 2025Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveAdministrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. SETTING AND
participantsAll adults (aged ≥ 18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. RESEARCH
designPatient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. MEASURES: Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated.
resultsSepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly.
conclusionsThis study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes.
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Registered trials
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