ArticleBMJ open2018
Validation of discharge diagnosis codes to identify serious infections among middle age and older adults.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
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- Severe infections, domain-specific cognitive vulnerability, and future infection risk in older adults.Brain, behavior, & immunity - health · 2026Article
- Comparing the mortality of patients with sepsis using empirical piperacillin/tazobactam and cefepime: analysis of the MIMIC-IV database.The Journal of antimicrobial chemotherapy · 2025Article
- A Machine Learning Approach for Identifying People With Neuroinfectious Diseases in Electronic Health Records: Algorithm Development and Validation.JMIR medical informatics · 2025Article
- Association of opioid and benzodiazepine coprescribing with adverse events among older adults with cancer.Journal of the National Cancer Institute · 2025Article
- Comorbidities and systemic steroids drive pneumonia risk in inflammatory bowel disease: Propensity score-matched cohort study.World journal of gastrointestinal pharmacology and therapeutics · 2025Article
- Transformers and large language models are efficient feature extractors for electronic health record studies.Communications medicine · 2025Article
- Hospital-Treated Infections and 15-year Incidence of Musculoskeletal Disorders: A Large Population-Based Cohort Study.Clinical epidemiology · 2025Article
- Incidence of chronic osteomyelitis between 2016 and 2022 in a large, multicenter database in the United States.Journal of bone and joint infection · 2025Article
- Hospital variation of outcomes in status epilepticus.Epilepsia · 2024Article
- Best Practices for Identifying Hospitalized Lower Respiratory Tract Infections Using Administrative Data: A Systematic Literature Review of Validation Studies.Infectious diseases and therapy · 2024Review
- Antibiotic Use in a Neonatal Intensive Care Unit Practicing Integrative Medicine-A Retrospective Analysis.Journal of integrative and complementary medicine · 2024Observational
- Incidence of acute kidney injury (AKI) and its impact on patient outcomes among adult hospitalized patients with carbapenem-resistant Gram-negative infections who received targeted treatment with a newer β-lactam or β-lactam/β-lactamase inhibitor-, polymyxin- or aminoglycoside-containing regimen.The Journal of antimicrobial chemotherapy · 2024Observational
- Increased ventilator utilization, ventilator-associated pneumonia, and mortality in non-COVID patients during the pandemic.Proceedings (Baylor University. Medical Center) · 2024Article
- Evolving etiologies, comorbidities, survival, and costs of care in adult encephalitis.Journal of neurovirology · 2023Article
- Clinical Risk Scores to Predict Nonsusceptibility to Trimethoprim-Sulfamethoxazole, Fluoroquinolone, Nitrofurantoin, and Third-Generation Cephalosporin Among Adult Outpatient Episodes of Complicated Urinary Tract Infection.Open forum infectious diseases · 2023Article
- Article
- Association Between Daily Average of Mobility Achieved During Physical Therapy Sessions and Hospital-Acquired or Ventilator-Associated Pneumonia among Critically Ill Patients.Journal of intensive care medicine · 2023Article
- Infection-related hospitalisation in young adults with systemic lupus erythematosus: data from the National Inpatient Sample.Lupus science & medicine · 2023Article
- Risk of post-fracture pneumonia and its association with cardiovascular events and mortality in adults with intellectual disabilities.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectivesHospitalisations for serious infections are common among middle age and older adults and frequently used as study outcomes. Yet, few studies have evaluated the performance of diagnosis codes to identify serious infections in this population. We sought to determine the positive predictive value (PPV) of diagnosis codes for identifying hospitalisations due to serious infections among middle age and older adults. SETTING AND
participantsWe identified hospitalisations for possible infection among adults >=50 years enrolled in the Tennessee Medicaid healthcare programme (2008-2012) using International Classifications of Diseases, Ninth Revision diagnosis codes for pneumonia, meningitis/encephalitis, bacteraemia/sepsis, cellulitis/soft-tissue infections, endocarditis, pyelonephritis and septic arthritis/osteomyelitis.
designMedical records were systematically obtained from hospitals randomly selected from a stratified sampling framework based on geographical region and hospital discharge volume. MEASURES: Two trained clinical reviewers used a standardised extraction form to abstract information from medical records. Predefined algorithms served as reference to adjudicate confirmed infection-specific hospitalisations. We calculated the PPV of diagnosis codes using confirmed hospitalisations as reference. Sensitivity analyses determined the robustness of the PPV to definitions that required radiological or microbiological confirmation. We also determined inter-rater reliability between reviewers.
resultsThe PPV of diagnosis codes for hospitalisations for infection (n=716) was 90.2% (95% CI 87.8% to 92.2%). The PPV was highest for pneumonia (96.5% (95% CI 93.9% to 98.0%)) and cellulitis (91.1% (95% CI 84.7% to 94.9%)), and lowest for meningitis/encephalitis (50.0% (95% CI 23.7% to 76.3%)). The adjudication reliability was excellent (92.7% agreement; first agreement coefficient: 0.91). The overall PPV was lower when requiring microbiological confirmation (45%) and when requiring radiological confirmation for pneumonia (79%).
conclusionsDischarge diagnosis codes have a high PPV for identifying hospitalisations for common, serious infections among middle age and older adults. PPV estimates for rare infections were imprecise.
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