Abstract
IntroductionAdministrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. We systematically reviewed the literature to assess the validity of case definitions of sepsis used with administrative data.MethodsEmbase and MEDLINE were searched for published articles with International Classification of Diseases (ICD) coded data used to define sepsis. s and full-text articles were reviewed in duplicate. Data were abstracted from all eligible full-text articles, including ICD-9- and/or ICD-10-based case definitions, sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).ResultsOf 2,317 individual studies identified, 12 full-text articles met all eligibility criteria. A total of 38 sepsis case definitions were tested, which included over 130 different ICD codes. The most common ICD-9 codes were 038.x, 790.7 and 995.92, and the most common ICD-10 codes were A40.x and A41.x. The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%. Other tests of diagnostic accuracy were reported only in some studies. Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.ConclusionsThe validity of administrative data in recording sepsis varied substantially across individual studies and ICD definitions. Our work may serve as a reference point for consensus towards an improved and harmonized ICD-coded definition of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0847-3) contains supplementary material, which is available to authorized users.
Highlights
Administrative health data have been used to study sepsis in large population-based studies
Sn ranged from 5.9% to 82.3%, and Sp ranged from 78.3% to 100%
Validated case definitions for sepsis have been reported with varying degrees of accuracy in studies using administrative data
Summary
Administrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. Sepsis is a life-threatening condition associated with a high mortality rate, significant health care costs and longterm consequences [1,2,3]. It is characterized by a spectrum of severity from mild acute organ dysfunction to multiorgan failure with complex pathophysiologic processes. Examples of administrative data include hospital discharge data, emergency visit data, physician claims and hospital insurance claims data. These data are advantageous, as they are
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