Comparing the validity of different ICD coding abstraction strategies for sepsis case identification in German claims data

Administrative data are used to generate estimates of sepsis epidemiology and can serve as source for quality indicators. Aim was to compare estimates on sepsis incidence and mortality based on different ICD-code abstraction strategies and to assess their validity for sepsis case identification based on a patient sample not pre-selected for presence of sepsis codes.

[...]

We used the national DRG-statistics for assessment of population-level sepsis

incidence and mortality. Cases were identified by three previously published

International Statistical Classification of Diseases (ICD) coding strategies

for sepsis based on primary and secondary discharge diagnoses (clinical sepsis

codes (R-codes), explicit coding (all sepsis codes) and implicit coding

(combined infection and organ dysfunction codes)).

[...]

Between 2007–2013, national sepsis incidence ranged between 231-1006/100,000

person-years depending on the coding strategy.


Conclusions

In the sample of a large tertiary care hospital, ICD-coding strategies for

sepsis differ in their accuracy. Estimates using R-codes are likely to

underestimate the true sepsis incidence, whereas implicit coding overestimates

sepsis cases. Further multi-center evaluation is needed to gain better

understanding on the validity of sepsis coding in Germany.


Comparing the validity of different ICD coding abstraction strategies for sepsis case identification in German claims data (PLOS One).


DOI: 10.1371/journal.pone.0198847