Understanding the biases to sepsis surveillance and quality assurance caused by inaccurate coding in administrative health data

败血症 医学 流行病学 诊断代码 入射(几何) 编码(社会科学) 急诊医学 回顾性队列研究 重症监护医学 内科学 统计 环境卫生 人口 数学 光学 物理
作者
Daniel Schwarzkopf,Norman Rose,Carolin Fleischmann,Barry P. Boden,Heike Dorow,Andreas Edel,Marcus Friedrich,Falk A. Gonnert,Jürgen Götz,Matthias Gründling,Markus Heim,Kirill Holbeck,Ulrich Jaschinski,Christian Koch,Christian Künzer,Khanh Le Ngoc,Simone Lindau,Ngoc B. Mehlmann,J. Meschede,Patrick Meybohm,Dominique Ouart,Christian Putensen,Michael Sander,Jens-Christian Schewe,Peter Schlattmann,Götz Schmidt,Gerhard Schneider,Claudia Spies,Ferdinand Steinsberger,Kai Zacharowski,Sebastian Zinn,Konrad Reinhart
出处
期刊:Infection [Springer Science+Business Media]
标识
DOI:10.1007/s15010-023-02091-y
摘要

Abstract Purpose Timely and accurate data on the epidemiology of sepsis are essential to inform policy decisions and research priorities. We aimed to investigate the validity of inpatient administrative health data (IAHD) for surveillance and quality assurance of sepsis care. Methods We conducted a retrospective validation study in a disproportional stratified random sample of 10,334 inpatient cases of age ≥ 15 years treated in 2015–2017 in ten German hospitals. The accuracy of coding of sepsis and risk factors for mortality in IAHD was assessed compared to reference standard diagnoses obtained by a chart review. Hospital-level risk-adjusted mortality of sepsis as calculated from IAHD information was compared to mortality calculated from chart review information. Results ICD-coding of sepsis in IAHD showed high positive predictive value (76.9–85.7% depending on sepsis definition), but low sensitivity (26.8–38%), which led to an underestimation of sepsis incidence (1.4% vs. 3.3% for severe sepsis-1). Not naming sepsis in the chart was strongly associated with under-coding of sepsis. The frequency of correctly naming sepsis and ICD-coding of sepsis varied strongly between hospitals (range of sensitivity of naming: 29–71.7%, of ICD-diagnosis: 10.7–58.5%). Risk-adjusted mortality of sepsis per hospital calculated from coding in IAHD showed no substantial correlation to reference standard risk-adjusted mortality ( r = 0.09). Conclusion Due to the under-coding of sepsis in IAHD, previous epidemiological studies underestimated the burden of sepsis in Germany. There is a large variability between hospitals in accuracy of diagnosing and coding of sepsis. Therefore, IAHD alone is not suited to assess quality of sepsis care.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
慕青应助毕春宇采纳,获得10
1秒前
orixero应助Alessnndre采纳,获得10
3秒前
aktuell发布了新的文献求助10
3秒前
5秒前
愉快的海完成签到,获得积分20
6秒前
星黛Lu完成签到,获得积分10
6秒前
8秒前
10秒前
愉快的海发布了新的文献求助10
10秒前
紫陌完成签到,获得积分0
10秒前
11秒前
lzh353512377发布了新的文献求助10
12秒前
蜗牛完成签到,获得积分20
13秒前
13秒前
14秒前
认真的TOTORO完成签到,获得积分10
14秒前
14秒前
胖川完成签到,获得积分10
15秒前
哈哈哈完成签到,获得积分10
16秒前
大个应助疯子魔煞采纳,获得30
17秒前
17秒前
18秒前
SIDEsss完成签到,获得积分0
18秒前
林平之完成签到,获得积分10
18秒前
FashionBoy应助liyingbin采纳,获得10
20秒前
20秒前
21秒前
共享精神应助JEAN采纳,获得10
21秒前
朵拉A梦完成签到,获得积分10
22秒前
搜集达人应助三岁半采纳,获得10
22秒前
科研通AI2S应助高兴的半仙采纳,获得10
22秒前
奥利奥爱好者完成签到,获得积分10
23秒前
23秒前
锦鲤完成签到 ,获得积分10
25秒前
Alessnndre完成签到,获得积分20
25秒前
26秒前
娇气的雁兰完成签到,获得积分10
26秒前
赵世璧发布了新的文献求助10
26秒前
无花果应助聪明的青寒采纳,获得10
27秒前
Kk完成签到,获得积分10
27秒前
高分求助中
The Mother of All Tableaux Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 2400
Ophthalmic Equipment Market by Devices(surgical: vitreorentinal,IOLs,OVDs,contact lens,RGP lens,backflush,diagnostic&monitoring:OCT,actorefractor,keratometer,tonometer,ophthalmoscpe,OVD), End User,Buying Criteria-Global Forecast to2029 2000
Cognitive Neuroscience: The Biology of the Mind (Sixth Edition) 1000
Optimal Transport: A Comprehensive Introduction to Modeling, Analysis, Simulation, Applications 800
Official Methods of Analysis of AOAC INTERNATIONAL 600
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 588
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3958068
求助须知:如何正确求助?哪些是违规求助? 3504219
关于积分的说明 11117555
捐赠科研通 3235582
什么是DOI,文献DOI怎么找? 1788351
邀请新用户注册赠送积分活动 871204
科研通“疑难数据库(出版商)”最低求助积分说明 802511