Epidemiology of sepsis, based on ICD-9 coding, a tertiary care experience from Pakistan

Abstract

IntroductionThere are limited studies on the burden of sepsis, from low to middle income countries (LMIC). We had carried out an analysis of the epidemiology of sepsis, in our hospital, a tertiary care university hospital in Pakistan, based on ICD-9 coding. MaterialsRetrospective data from electronic discharge records of all patients aged 17 or above, admitted with sepsis from January 2013–January 2014, at our hospital was taken. A validated method requiring a combination of two ICD-9 codes (international classification of diseases, ninth revision, clinical modification) representing infections and acute organ dysfunction, based on the Angus and Martin methodology, along with ICD-9 codes for sepsis, severe sepsis and septic shock, were used to abstract data. ResultsOverall, 8759 patients were identified to have sepsis or severe sepsis, out of total 31,111 admissions between 2013 and 14. Out of these cases, 61.25% (5365) had sepsis while 38.75% (3394) had severe sepsis or septic shock. Out of the total 8759 patients, 58.10% (5089) remained in the ward. 31.93% (2797) utilized the intermediate Care Unit while 9.97% (873) utilized the Intensive Care Unit (ICU). The overall mortality with sepsis, was found to be 9.8% and mortality from septic shock to be around 22.8%. The common comorbidities were diabetes (22.8%), renal disease (14.7%) and COPD (14.7%). The mean length of hospital stay was 3.7 days in mild disease, compared to 7.5 days, in severe sepsis and septic shock group. ConclusionsThe first ICD -9 coding-based study signifies a high burden of disease, along with high mortality from septic shock.