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

Background International Classification of Diseases 10th edition (ICD-10) is widely used to describe the burden of disease. Aim To describe how well ICD-10 coding captures sepsis in children admitted to the hospital with blood culture-proven bacterial or fungal infection and systemic inflammatory response syndrome. Methods Secondary analysis of a population-based, multicenter, prospective cohort study on children with blood culture-proven sepsis of nine tertiary pediatric hospitals in Switzerland. We compared the agreement of validated study data on sepsis criteria with ICD-10 coding abstraction obtained at the participating hospitals. Results We analyzed 998 hospital admissions of children with blood culture-proven sepsis. The sensitivity of ICD-10 coding abstraction was 60% (95%-CI 57–63) for sepsis; 35% (95%-CI 31–39) for sepsis with organ dysfunction, using an explicit abstraction strategy; and 65% (95%-CI 61–69) using an implicit abstraction strategy. For septic shock, the sensitivity of ICD-10 coding abstraction was 43% (95%-CI 37–50). Agreement of ICD-10 coding abstraction with validated study data varied by the underlying infection type and disease severity ( p