Skip to main content
bioRxiv
  • Home
  • About
  • Submit
  • ALERTS / RSS
Advanced Search
New Results

Evaluation of the Angus ICD9-CM Sepsis Abstraction Criteria

View ORCID ProfileSteven Horng, Larry A. Nathanson, David A. Sontag, Nathan I. Shapiro
doi: https://doi.org/10.1101/124289
Steven Horng
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Steven Horng
  • For correspondence: shorng@bidmc.harvard.edu
Larry A. Nathanson
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David A. Sontag
New York University, New York, NY
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nathan I. Shapiro
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Abstract
  • Full Text
  • Info/History
  • Metrics
  • Supplementary material
  • Preview PDF
Loading

Abstract

Objective Validate the infection component of the Angus International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9-CM) sepsis abstraction criteria

Design Observational cohort study

Setting 55,000 visits/year Adult Emergency Department (ED)

Patients All consecutive ED patient visits between 12/16/2011 and 08/13/2012 were included in the study. Patients were excluded if there was a missing outcome measure.

Interventions None.

Measurements and Main Results The primary outcome measure was suspected infection at conclusion of the ED work-up as judged by the physician. There were 34,796 patients who presented to the ED between 12/16/11 and 8/13/12, of which 31,755 (91%) patients were included and analyzed. The original Angus sepsis abstraction criteria had a sensitivity of 55%, specificity of 97%, PPV of 82%, NPV of 88%, accuracy of 87%, and a F1 score of 0.66. The modified Angus sepsis abstraction criteria which includes codes added after the original publication had a sensitivity of 65%, specificity of 96%, PPV of 81%, NPV of 91%, accuracy of 89%, and F1 score of 0.72.

Conclusions In our study, the Angus abstraction criteria have high specificity (97%), but moderate sensitivity (55%) in identifying patients with suspected infection as defined by physician at the time of disposition from the emergency department. Given these findings, it is likely that we are underestimating the true incidence of sepsis in the United States and worldwide.

Footnotes

  • Funding Support This work was supported by CIMIT Award No. 12-1262 under U.S. Army Medical Research Acquisition Activity Cooperative Agreement W81XWH-09-2-0001. The information contained herein does not necessarily reflect the position or policy of the Government, and no official endorsement should be inferred.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
Back to top
PreviousNext
Posted April 12, 2017.
Download PDF

Supplementary Material

Email

Thank you for your interest in spreading the word about bioRxiv.

NOTE: Your email address is requested solely to identify you as the sender of this article.

Enter multiple addresses on separate lines or separate them with commas.
Evaluation of the Angus ICD9-CM Sepsis Abstraction Criteria
(Your Name) has forwarded a page to you from bioRxiv
(Your Name) thought you would like to see this page from the bioRxiv website.
Share
Evaluation of the Angus ICD9-CM Sepsis Abstraction Criteria
Steven Horng, Larry A. Nathanson, David A. Sontag, Nathan I. Shapiro
bioRxiv 124289; doi: https://doi.org/10.1101/124289
Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Citation Tools
Evaluation of the Angus ICD9-CM Sepsis Abstraction Criteria
Steven Horng, Larry A. Nathanson, David A. Sontag, Nathan I. Shapiro
bioRxiv 124289; doi: https://doi.org/10.1101/124289

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Subject Area

  • Bioinformatics
Subject Areas
All Articles
  • Animal Behavior and Cognition (1526)
  • Biochemistry (2480)
  • Bioengineering (1739)
  • Bioinformatics (9683)
  • Biophysics (3903)
  • Cancer Biology (2972)
  • Cell Biology (4195)
  • Clinical Trials (135)
  • Developmental Biology (2627)
  • Ecology (4102)
  • Epidemiology (2031)
  • Evolutionary Biology (6898)
  • Genetics (5206)
  • Genomics (6501)
  • Immunology (2184)
  • Microbiology (6945)
  • Molecular Biology (2752)
  • Neuroscience (17281)
  • Paleontology (126)
  • Pathology (427)
  • Pharmacology and Toxicology (706)
  • Physiology (1057)
  • Plant Biology (2489)
  • Scientific Communication and Education (643)
  • Synthetic Biology (831)
  • Systems Biology (2689)
  • Zoology (430)