Observational studyCritical care medicine2019
Comparison of Methods for Identification of Pediatric Severe Sepsis and Septic Shock in the Virtual Pediatric Systems Database.
Observational study in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Article
- Fast, Accurate Assignment of Clinical Diagnoses From Patient Notes by a Large Language Model: Critical Pediatric Pneumonia as a Use Case.Critical care explorations · 2025Article
- Frequency of and Risk Factors for Increased Healthcare Utilization After Pediatric Sepsis Hospitalization.Critical care medicine · 2024Observational
- Racial and Ethnic Differences in Length of Stay for US Children Hospitalized for Acute Osteomyelitis.The Journal of pediatrics · 2023Article
- Sensitivity of ICD coding for sepsis in children-a population-based study.Intensive care medicine. Paediatric and neonatal · 2023Article
- Sepsis-Related Brain MRI Abnormalities Are Associated With Mortality and Poor Neurological Outcome in Pediatric Sepsis.Pediatric neurology · 2022Article
- Hospital outcomes for children with severe sepsis in the USA by race or ethnicity and insurance status: a population-based, retrospective cohort study.The Lancet. Child & adolescent health · 2021Article
- Implementation of a Follow-Up System for Pediatric Sepsis Survivors in a Large Academic Pediatric Intensive Care Unit.Frontiers in pediatrics · 2021Article
- Identification of Potential Early Diagnostic Biomarkers of Sepsis.Journal of inflammation research · 2021Article
- Risk of Mortality in Immunocompromised Children With Severe Sepsis and Septic Shock.Critical care medicine · 2020Article
- Sepsis Computable Phenotypes in the Service of Observational Research.Critical care medicine · 2019Article
- Application of the Improving Pediatric Sepsis Outcomes Definition for Pediatric Sepsis to Nationally Representative Emergency Department Data.Pediatric quality & safetyArticle
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Authors and funding
8 authors.
Funding
Abstract
objectivesTo compare the performance of three methods of identifying children with severe sepsis and septic shock from the Virtual Pediatric Systems database to prospective screening using consensus criteria.
designObservational cohort study.
settingSingle-center PICU. PATIENTS: Children admitted to the PICU in the period between March 1, 2012, and March 31, 2014.
interventionsNone. MEASUREMENTS AND MAIN
resultsDuring the study period, all PICU patients were prospectively screened daily for sepsis, and those meeting consensus criteria for severe sepsis or septic shock on manual chart review were entered into the sepsis registry. Of 7,459 patients admitted to the PICU during the study period, 401 met consensus criteria for severe sepsis or septic shock (reference standard cohort). Within Virtual Pediatric Systems, patients identified using "Martin" (n = 970; κ = 0.43; positive predictive value = 34%; F1 = 0.48) and "Angus" International Classification of Diseases, 9th Edition, Clinical Modification codes (n = 1387; κ = 0.28; positive predictive value = 22%; F1 = 0.34) showed limited agreement with the reference standard cohort. By comparison, explicit International Classification of Diseases, 9th Edition, Clinical Modification codes for severe sepsis (995.92) and septic shock (785.52) identified a smaller, more accurate cohort of children (n = 515; κ = 0.61; positive predictive value = 57%; F1 = 0.64). PICU mortality was 8% in the reference standard cohort and the cohort identified by explicit codes; age, illness severity scores, and resource utilization did not differ between groups. Analysis of discrepancies between the reference standard and Virtual Pediatric Systems explicit codes revealed that prospective screening missed 66 patients with severe sepsis or septic shock. After including these patients in the reference standard cohort as an exploratory analysis, agreement between the cohort of patients identified by Virtual Pediatric Systems explicit codes and the reference standard cohort improved (κ = 0.73; positive predictive value = 70%; F1 = 0.75).
conclusionsChildren with severe sepsis and septic shock are best identified in the Virtual Pediatric Systems database using explicit diagnosis codes for severe sepsis and septic shock. The accuracy of these codes and level of clinical detail available in the Virtual Pediatric Systems database allow for sophisticated epidemiologic studies of pediatric severe sepsis and septic shock in this large, multicenter database.
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