Table 2.
Accuracy of identification of cases with infection or sepsis by explicit ICD-10-codes
| Explicit coding of infection or sepsis | Reference standard from chart review | Predictive accuracy of explicit coding of infection or sepsis | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Proportion of hospital admissions | Hospital mortality | N missing | Proportion of hospital admissions | Hospital mortality | Sensitivity | Specificity | PPV | NPV | |
| All cases | |||||||||
| Infection | 23.7% [22%; 25.4%] | 6% [4.5%; 8.1%] | 0/10,384 | 20.6% [18.3%; 23.2%] | 6.7% [5%; 9%] | 79.1% [71.8%; 84.9%] | 90.7% [89.2%; 92%] | 68.9% [63.6%; 73.8%] | 94.4% [91.8%; 96.2%] |
| Sepsis-1 | 2.3% [1.8%; 3%] | 28% [20.9%; 36.3%] | 185/10,384 | 6.5% [5.6%; 7.5%] | 16.2% [11.6%; 22.2%] | 27.5% [19.7%; 36.9%] | 99.5% [99.1%; 99.7%] | 78.3% [65.4%; 87.3%] | 95.2% [94.1%; 96%] |
| Severe sepsis-1 | 1.4% [0.8%; 2.3%] | 41.9% [29.1%; 55.9%] | 275/10,384 | 3.3% [2.6%; 4.1%] | 27.8% [21%; 35.8%] | 34.4% [21.6%; 49.9%] | 99.8% [99.6%; 99.8%] | 83.3% [71.6%; 90.8%] | 97.8% [97.4%; 98.2%] |
| Septic shock-1 | 0.5% [0.3%; 0.9%] | 61% [46.6%; 73.8%] | 305/10,384 | 1.6% [1.3%; 2%] | 44.9% [38.5%; 51.4%] | 26.8% [14.9%; 43.3%] | 99.9% [99.8%; 100%] | 85.7% [61.2%; 95.8%] | 98.8% [98.5%; 99.1%] |
| Sepsis-3 | 1.4% [0.8%; 2.3%] | 41.9% [29.1%; 55.9%] | 658/10,384 | 2.9% [1.9%; 4.3%] | 31.2% [22.7%; 41.1%] | 38.0% [28.6%, 48.5%] | 99.8% [99.6%, 99.9%] | 84.5% [69.2%, 93.0%] | 98.2% [97.5%, 98.7%] |
| Septic shock-3 | 0.5% [0.3%; 0.9%] | 61% [46.6%; 73.8%] | 439/10,384 | 1.1% [0.8%; 1.5%] | 54.4% [47.6%; 60.9%] | 35.7% [19.1%, 56.6%] | 99.9% [99.8%, 99.9%] | 76.9% [65.0%, 85.7%] | 99.3% [98.9%, 99.5%] |
| No ICU-treatment | |||||||||
| Infection | 21.0% [19.4%, 22.7%] | 2.6% [1.1%, 6.0%] | 0/5565 | 17.6% [15.0%, 20.5%] | 2.8% [1.2%, 6.3%] | 77.5% [69.1%; 84.1%] | 91.1% [89.7%; 92.3%] | 64.9% [59.1%; 70.4%] | 95.0% [92.3%; 96.8%] |
| Sepsis-1 | 1.1% [0.8%, 1.6%] | 12.8% [3.3%, 38.8%] | 114/5565 | 4.2% [3.3%, 5.1%] | 7.5% [2.6%, 20.0%] | 17.4% [9.9%; 28.7%] | 99.6% [99.2%; 99.8%] | 63.9% [43.5%; 80.2%] | 96.5% [95.4%; 97.4%] |
| Severe sepsis-1 | 0.4% [0.2%; 1.1%] | 23.4% [4.1%; 68.4%] | 166/5565 | 1.3% [0.9%; 1.7%] | 14.6% [4.9%; 36.3%] | 24.8% [9.4%; 51.1%] | 99.9% [99.8%; 99.9%] | 70.5% [50.4%; 84.9%] | 99.0% [98.7%; 99.3%] |
| Septic shock | 0% [0%; 0.1%] | 50.4% [15.4%; 85%] | 179/5565 | 0.1% [0.1%; 0.3%] | 37.6% [10.3%; 76%] | 3.0% [0.4%; 18.8%] | 100.0% [99.9%; 100.0%] | 18.4% [0.1%; 98.9%] | 99.9% [99.7%; 99.9%] |
| Sepsis-3 | 0.4% [0.2%; 1.1%] | 23.4% [4.1%; 68.4%] | 390/5565 | 0.9% [0.5%; 1.6%] | 13.7% [3.4%; 41.3%] | 28.6% [14.8%, 48.0%] | 99.9% [99.7%, 99.9%] | 68.7% [35.7%, 89.6%] | 99.4% [99.1%, 99.6%] |
| Septic shock-3 | 0% [0%; 0.1%] | 50.4% [15.4%; 85%] | 306/5565 | 0% [0%; 0.2%] | 48.2% [6.4%; 92.7%] | 10.4% [2.8%, 32.2%] | 100.0% [99.8%, 100.0%] | 14.8% [0.1%, 98.3%] | 100.0% [99.8%, 100.0%] |
| ICU-treatment | |||||||||
| Infection | 44.9% [42.1%, 47.8%] | 18.5% [16.1%, 21.0%] | 0/4819 | 44.5% [40.9%, 48.2%] | 19.1% [16.0%, 22.6%] | 84.3% [79.3%; 88.3%] | 86.6% [81.4%; 90.5%] | 83.5% [76.2%; 88.8%] | 87.3% [83.6%; 90.3%] |
| Sepsis-1 | 11.3% [9.1%, 13.9%] | 40.1% [33.7%, 47.0%] | 71/4819 | 25.0% [20.0%, 30.8%] | 27.6% [24.0%, 31.5%] | 40.4% [34.1%; 47.2%] | 98.4% [96.9%; 99.2%] | 89.4% [77.5%; 95.4%] | 83.2% [78.5%; 87.1%] |
| Severe sepsis-1 | 8.4% [5.8%; 12%] | 49.7% [42.8%; 56.6%] | 109/4819 | 18.8% [14.7%; 23.8%] | 34.7% [29%; 40.9%] | 39.4% [28.6%; 51.4%] | 98.8% [97.6%; 99.4%] | 88.6% [74.8%; 95.3%] | 87.5% [83.8%; 90.5%] |
| Septic shock-1 | 4.2% [2.4%; 7.3%] | 61.9% [49.4%; 73.1%] | 126/4819 | 12.9% [9.9%; 16.7%] | 45.5% [39.5%; 51.6%] | 28.7% [16.2%; 45.7%] | 99.4% [98.6%; 99.8%] | 88.6% [70.1%; 96.3%] | 90.4% [87.2%; 92.8%] |
| Sepsis-3 | 8.4% [5.8%; 12%] | 49.7% [42.8%; 56.6%] | 268/4819 | 18.5% [12.6%; 26.3%] | 37.4% [30%; 45.3%] | 41.3% [32.4%, 50.7%] | 98.9% [97.9%, 99.5%] | 89.7% [76.6%, 95.9%] | 88.1% [82.5%, 92.1%] |
| Septic shock-3 | 4.2% [2.4%; 7.3%] | 61.9% [49.4%; 73.1%] | 133/4819 | 9.5% [6.9%; 12.9%] | 54.3% [48%; 60.5%] | 36.1% [19.7%, 56.6%] | 99.0% [98.3%, 99.5%] | 79.6% [74.2%, 84.1%] | 93.7% [90.2%, 96.0%] |
Missing values on the reference standard result from lacking information on criteria of sepsis in medical records, absolute frequencies give numbers for the sample. Estimates of proportion of infection or sepsis cases, hospital mortality, sensitivity, specificity, PPV (positive predictive value), and NPV (negative predictive value) are adjusted for sampling weights and clustering and are reported with their 95% confidence intervals (CI)