Wilhelms S B, Walther S M, Huss F, Sjöberg F
Department of Anaesthesia and Intensive Care, Linköping University, Linköping, Sweden.
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Acta Anaesthesiol Scand. 2017 Feb;61(2):186-193. doi: 10.1111/aas.12814. Epub 2016 Oct 4.
Different International Classification of Diseases (ICD)-based code abstraction strategies have been used when studying the epidemiology of severe sepsis. The aim of this study was to compare three previously used ICD code abstraction strategies to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus criteria for severe sepsis, in a setting of intensive care patients.
All patients (≥ 18 years of age) with severe sepsis according to the ACCP/SCCM criteria registered in the Swedish Intensive Care Registry (2005-2009) were included in the study. Using the Swedish National Patient Register, we investigated whether these patients fulfilled an ICD code compilation for severe sepsis at hospital discharge.
Overall, 9271 patients with severe sepsis were registered in the Swedish Intensive Care Registry. A majority of these patients (55.4%) were discharged from the hospital with ICD codes that did not correspond to any of the ICD code compilations. A minority of patients (10.3%) were discharged with ICD codes corresponding to all three code abstraction strategies applied. Overall, the proportion of patients discharged with ICD codes corresponding to the criteria of Angus et al. was 15.1%, to the criteria of Flaatten was 39.8%, and to the criteria of Martin et al. was 16.0%.
A majority of patients with severe sepsis according to the ACCP/SCCM criteria were not discharged with ICD codes corresponding to the ICD code abstraction strategies; thus, the abstraction strategies did not identify the correct patients.
在研究严重脓毒症的流行病学情况时，人们采用了基于不同国际疾病分类（ICD）的编码提取策略。本研究旨在将三种先前使用的ICD编码提取策略与美国胸科医师学会/危重病医学会（ACCP/SCCM）关于严重脓毒症的共识标准进行比较，研究对象为重症监护患者。
纳入瑞典重症监护登记处（2005 - 2009年）中所有符合ACCP/SCCM标准的严重脓毒症患者（年龄≥18岁）。利用瑞典国家患者登记处，我们调查了这些患者出院时是否符合严重脓毒症的ICD编码编制。
总体而言，瑞典重症监护登记处登记了9271例严重脓毒症患者。这些患者中的大多数（55.4%）出院时的ICD编码与任何一种ICD编码编制均不对应。少数患者（10.3%）出院时的ICD编码与所应用的所有三种编码提取策略均相符。总体而言，出院时ICD编码符合安格斯等人标准的患者比例为15.1%，符合弗拉滕标准的为39.8%，符合马丁等人标准的为16.0%。
根据ACCP/SCCM标准诊断为严重脓毒症的大多数患者出院时的ICD编码与ICD编码提取策略不对应；因此，这些提取策略未能识别出正确的患者。
