Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Crit Care Med. 2020 Dec;48(12):1881-1884. doi: 10.1097/CCM.0000000000004577.
Describe the epidemiology of sepsis across the transition from the International Classification of Diseases, 9th Edition, and International Classification of Diseases, 10th Edition, coding systems, evaluating estimates of two previously published International Classification of Diseases, 10th Edition, coding strategies.
Serial cross-sectional analysis.
Healthcare Utilization Project's annual Nationwide Inpatient Sample of U.S. hospital discharges, 2012-2017.
Discharges greater than or equal to 18 years old, which met one of the three case definitions for sepsis. For the records using International Classification of Diseases, 9th Edition, we used previously published modified Angus criteria, and for records using International Classification of Diseases, 10th Edition, we deployed a case definition used by the Centers for Medicare & Medicaid Services and a case definition developed by the Institute for Health Metrics and Evaluation.
None.
During the study period, there were discontinuities in the sepsis incidence estimates using the modified Angus International Classification of Diseases, 9th Edition, criteria in 2014 and either Centers for Medicare & Medicaid Services or Institute for Health Metrics and Evaluation International Classification of Diseases, 10th Edition, criteria in 2016. In 2014, there were an estimated 1,009 cases (95% CI, 989-1,030) of modified Angus sepsis per 100,000 persons, whereas in 2016, there were 709 cases (95% CI, 694-724) of Centers for Medicare & Medicaid Services sepsis and 1,498 cases (95% CI, 1,471-1,092) of Institute for Health Metrics and Evaluation sepsis per 100,000 persons. Furthermore, the Institute for Health Metrics and Evaluation definition identified a sepsis cohort with similar hospital characteristics but a younger age distribution, higher proportion of women, lower severity of illness, and lower hospital mortality.
The Institute for Health Metrics and Evaluation International Classification of Diseases, 10th Edition, coding strategy for identifying sepsis may capture a larger patient population within administrative datasets that are different from those identified with previously deployed International Classification of Diseases-based methods. Further work is required to determine the optimal International Classification of Diseases, 10th Edition, coding strategy for use in hospital discharge data.
描述从国际疾病分类第 9 版到第 10 版编码系统过渡期间败血症的流行病学，评估两种先前发表的国际疾病分类第 10 版编码策略的估计值。
连续横断面分析。
医疗保健利用项目的美国医院出院年度全国住院患者样本，2012-2017 年。
年龄大于或等于 18 岁，符合败血症的三个病例定义之一。对于使用国际疾病分类第 9 版的记录，我们使用了先前发表的修改后的安格斯标准，对于使用国际疾病分类第 10 版的记录，我们使用了医疗保险和医疗补助服务中心的病例定义和卫生计量与评估研究所制定的病例定义。
无。
在研究期间，使用修改后的安格斯国际疾病分类第 9 版标准的败血症发病率估计值在 2014 年和医疗保险和医疗补助服务中心或卫生计量与评估研究所国际疾病分类第 10 版标准在 2016 年存在不连续。2014 年，每 100,000 人中估计有 1,009 例（95%CI，989-1,030）修改后的安格斯败血症病例，而 2016 年，每 100,000 人中分别有 709 例（95%CI，694-724）医疗保险和医疗补助服务中心败血症病例和 1,498 例（95%CI，1,471-1,092）卫生计量与评估研究所败血症病例。此外，卫生计量与评估研究所的定义确定了一个具有类似医院特征但年龄分布更年轻、女性比例更高、疾病严重程度更低和医院死亡率更低的败血症队列。
卫生计量与评估研究所国际疾病分类第 10 版编码策略用于识别败血症可能会在行政数据集内捕获更大的患者人群，这些患者人群与先前部署的基于国际疾病分类的方法不同。需要进一步努力确定用于医院出院数据的最佳国际疾病分类第 10 版编码策略。
