Accuracy of the modified Global Burden of Disease International Classification of Diseases coding methods for identifying sepsis: a prospective multicentre cohort study

作者：Ashwani Kumar, Balasubramanian Venkatesh, Simon Finfer, Anthony Delaney, Kelly Thompson, Paul M Middleton, Anders Åneman, Kavitha Shetty, Deepak Bhonagiri, Manoj Saxena, Frank van Haren, Celia Bradford, Graham Reece, Simon Rodda, Candice Mackellar, Frances Bass, Lewis Tsang, Sandra Li, Raymond Kwok, Alexander Buckley, Angela E. Zou, Swathi Sridharan, David Hu, Mark Iskandar, S Frost, Tori Headington, Giuliana Connor, Anthony Klironomos, Sana Shan, Li Yang, Belinda Anderson, Rebecca Sidoli, Deborah Inskip, Matthew Lam, Garnette Fuller, Christopher Yu, B Sigurdson, Richard McNulty, Maeda Sadeghpour, Laurent Billot, Naomi Hammond · 发表于：Critical Care · 年份：2025 · DOI：10.1186/s13054-025-05448-x · 被引用次数：10 · 研究领域：Sepsis Diagnosis and Treatment、Medical Coding and Health Information、Autopsy Techniques and Outcomes

BACKGROUND: This study assessed the accuracy of three International Classification of Diseases (ICD) codes methods derived from Global Burden of Disease (GBD) sepsis study (modified GBD method) in identifying sepsis, compared to the Angus method. Sources of errors in these methods were also reported. METHODS: Prospective multicentre, observational, study. Emergency Department patients aged ≥ 16 years with high sepsis risk from nine hospitals in NSW, Australia were screened for clinical sepsis using Sepsis 3 criteria and coded as having sepsis or not using the modified GBD and Angus methods. The three modified GBD methods were: Explicit-sepsis-specific ICD code recorded; Implicit-sepsis-specific code or infection as primary ICD code plus organ dysfunction code; Implicit plus-as for Implicit but infection as primary or secondary ICD code. Agreement between clinical sepsis and ICD coding methods was assessed using Cronbach alpha (α). For false positive cases (ICD-coded sepsis but not clinically diagnosed), the ICD codes leading to those errors were documented. For false negatives (clinically diagnosed sepsis but ICD-coded), uncoded sources of infection and organ dysfunction were documented. RESULTS: Of 6869 screened patients, 450 (median age 72.4 years, 48.9% females) met inclusion criteria. Clinical sepsis was diagnosed in 215/450 (47.8%). The explicit, implicit, implicit plus and Angus methods identified sepsis in 108/450 (24.0%), 175/450 (38.9%), 222/450 (49.3%) and 170/450 (...