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Sepsis surveillance from administrative data in the absence of a perfect verification
  • Published Date:
    Aug 20 2016
  • Source:
    Ann Epidemiol. 26(10):717-722.e1.


Public Access Version Available on: October 01, 2017 information icon
Please check back on the date listed above.
Details:
  • Pubmed ID:
    27600804
  • Pubmed Central ID:
    PMC5086291
  • Description:
    Purpose

    Past studies of sepsis epidemiology did not address misclassification bias due to imperfect verification of sepsis detection methods to estimate the true prevalence.

    Methods

    We examined 273 126 hospitalizations from 2008–2012 at a tertiary-care center to develop surveillance-aimed sepsis detection criteria, based on the presence of the sepsis explicit International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes (995.92 or 785.52), blood culture orders, and antibiotics administration. We used Bayesian multinomial latent class models to estimate the true prevalence of sepsis, while adjusting for the imperfect sensitivity and specificity and the conditional dependence among the individual criteria.

    Results

    The apparent annual prevalence of sepsis hospitalizations based on explicit ICD-9-CM codes were 1.5%, 1.4%, 1.6%, 2.2%, and 2.5% for the years 2008 to 2012. Bayesian posterior estimates for the true prevalence of sepsis suggested that it remained stable from 2008, 19.2% (95% credible interval [CI]: 17.9%, 22.9%), to 2012, 17.8% (95% CI: 16.8%, 20.2%). The sensitivity of sepsis-explicit codes, however, increased from 7.6% (95% CI: 6.4%, 8.4%) in 2008 to 13.8% (95% CI: 12.2%, 14.9%) in 2012.

    Conclusions

    The true prevalence of sepsis remained high, but stable despite an increase in the sensitivity of sepsis-explicit codes in administrative data.

  • Document Type:
  • Collection(s):
  • Funding:
    U54 CK000162/CK/NCEZID CDC HHS/United States
    U54 CK000172/CK/NCEZID CDC HHS/United States
    UL1 TR000448/TR/NCATS NIH HHS/United States
  • Supporting Files:
    No Additional Files
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