Table 2.

Agreement in hospital performance rankings between different methods of identifying “septic shock” within hospital claims data.

Septic shock cohort comparisons	Hospital risk-standardized mortality, Intra-class correlation coefficient, p-value	Hospital Ranking Outlier classification, Kappa statistic (95% CI)	Hospital Ranking Quartile classification, Kappa statistic (95% CI)
Primary analysis
Implicit septic shock (any duration) vs. ICD-9 septic shock	0.72, p<0.001	0.44 (0.30-0.58)	0.53 (0.47-0.60)
Sensitivity analyses
Implicit septic shock (any duration) vs. implicit septic shock (minimum antibiotics and vasopressor duration)	0.76, p<0.001	0.60 (0.47-0.73)	0.52 (0.46-0.59)
Implicit septic shock (minimum antibiotics and vasopressor duration) vs. ICD-9 septic shock	0.62, p<0.001	0.35 (0.19-0.50)	0.44 (0.37- 0.51)
ICD-9 septic shock vs. ICD-9 sepsis	0.74, p<0.001	0.32 (0.23-0.42)	0.62 (0.56-0.68)

Implicit septic shock (any duration) definition: Any blood culture, antibiotics, and vasopressors charged during first 2 hospital days.

Implicit septic shock (minimum antibiotics and vasopressor duration) definition: Charges for blood culture, and at least 4 days of antibiotics and 2 days of vasopressors (unless death precedes minimum duration), starting within the first 2 hospital days.

ICD-9 septic shock: ICD-9 038.x for septicemia present on admission with ICD-9 785.52 for septic shock.

ICD-9 sepsis: ICD-9 038.x for septicemia present on admission