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.
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).