2008-21 年脓毒症编码实践。

Coding practice for sepsis 2008-21.

机构信息

Avdeling for anestesi- og intensivmedisin, Sykehuset Levanger, og, Midt-norsk senter for sepsisforskning, Institutt for sirkulasjon og bildediagnostikk, NTNU.

Institutt for klinisk og molekylær medisin, Fakultetet for medisin og helsevitenskap, NTNU, og, Avdeling for medisinsk mikrobiologi, St. Olavs hospital.

出版信息

Tidsskr Nor Laegeforen. 2024 Feb 26;144(3). doi: 10.4045/tidsskr.23.0271. Print 2024 Feb 27.

DOI:10.4045/tidsskr.23.0271

PMID:38415570

Abstract

BACKGROUND

Sepsis has a high incidence and mortality rate. Accurate data are needed for health service planning and for research, and there is a need to identify coding practices in Norway.

MATERIAL AND METHOD

All patients over 17 years of age who had been admitted to Norwegian hospitals with sepsis in the period 2008-21 were identified using diagnostic codes for infection plus organ failure, and specific codes for sepsis, from the Norwegian Patient Registry.

RESULTS

There were 317 705 admissions with diagnostic codes for sepsis, of which 210 391 (66.2 %) were sepsis with a known focus, 77 627 (24.4 %) were of unknown focus and 29 687 (9.3 %) were codes for both a known and unknown focus. The percentage of sepsis episodes coded with a known focus varied between the health regions. The highest percentage was in the Western Norway Regional Health Authority (72.1 %, 95 % confidence interval (CI): 71.8 to 72.5), and the lowest was in the Central Norway Regional Health Authority (59.2 %, 95 %, CI 58.7 to 59.7). The use of codes with a known focus increased each year on average by 3.2 % (95 % CI 2.7 to 3.6, from 47.5 % in 2008 to 82.3 % in 2021), while the use of codes with an unknown focus decreased by 2.3 % (95 % CI -2.7 to -1.9) from 37.8 % in 2008 to 13.0 % in 2021. Known and unknown focus combined also decreased by 0.9 % per year on average (95 % CI -1.0 to -0.8) from 14.3 % in 2008 to 4.1 % in 2021.

INTERPRETATION

The coding of sepsis in Norwegian hospitals has become more uniform.

摘要

背景

脓毒症发病率和死亡率高，需要准确的数据来进行卫生服务规划和研究，因此有必要确定挪威的编码实践。

材料和方法

使用挪威患者登记处的感染加器官衰竭诊断代码和脓毒症特定代码，确定 2008-21 年间在挪威医院因脓毒症入院的所有 17 岁以上患者。

结果

有 317705 例入院诊断为脓毒症，其中 210391 例（66.2%）为已知病灶的脓毒症，77627 例（24.4%）为未知病灶，29687 例（9.3%）为已知和未知病灶的编码。编码有明确病灶的脓毒症病例百分比在各卫生区域之间存在差异。西部地区挪威区域卫生局（72.1%，95%置信区间（CI）：71.8 至 72.5）的比例最高，而中央挪威区域卫生局（59.2%，95%CI 58.7 至 59.7）的比例最低。平均而言，每年使用明确病灶的编码增加 3.2%（95%CI 2.7 至 3.6，从 2008 年的 47.5%增加到 2021 年的 82.3%），而使用未知病灶的编码减少 2.3%（95%CI -2.7 至 -1.9）从 2008 年的 37.8%降至 2021 年的 13.0%。已知和未知病灶的综合编码也平均每年减少 0.9%（95%CI -1.0 至 -0.8），从 2008 年的 14.3%降至 2021 年的 4.1%。