Sensitivity of ICD coding for sepsis in children-a population-based study

Area of Science:

• Pediatric infectious diseases
• Health informatics
• Epidemiology

Background:

• The International Classification of Diseases 10th edition (ICD-10) is a standard tool for disease burden assessment.
• Accurate coding is crucial for understanding disease prevalence and guiding public health interventions.

Purpose of the Study:

• To evaluate the accuracy of ICD-10 coding in identifying pediatric sepsis cases.
• To compare ICD-10 coding with validated research data for sepsis and related conditions in hospitalized children.

Main Methods:

• A secondary analysis of a prospective, multicenter cohort study involving nine Swiss pediatric hospitals.
• Comparison of validated sepsis criteria data with ICD-10 coding abstraction for 998 hospital admissions of children with blood culture-proven sepsis.

Main Results:

• ICD-10 coding sensitivity for sepsis was 60% (explicit) and 65% (implicit).
• Sensitivity for sepsis with organ dysfunction was only 35% (explicit).
• ICD-10 coding significantly underestimated the national incidence of pediatric sepsis compared to validated data.

Conclusions:

• ICD-10 coding provides a poor representation of sepsis and sepsis with organ dysfunction in children.
• Current ICD-10 coding practices may severely underestimate the true prevalence of pediatric sepsis.
• Improved coding strategies are needed for accurate pediatric sepsis surveillance.