Su Yeon Lee, Mi Hyeon Park, Dong Kyu Oh, Chae-Man Lim
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We therefore aimed to validate the diagnostic accuracy of the ASE and to assess the prevalence and mortality of sepsis using ASE.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>A single center in South Korea, with 2732 beds including 221 ICU beds.</p><p><strong>Patients: </strong>During the validation phase, adult patients who were hospitalized or visiting the emergency department between November 5 and November 11, 2019, were included. In the subsequent phase of epidemiologic analysis, we included adult patients who were admitted from January to December 2020.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>ASE had a sensitivity of 91.6%, a specificity of 98.3%, a positive predictive value (PPV) of 57.4%, and a negative predictive value of 99.8% when compared with the Sepsis-3 definition. Of 126,998 adult patient hospitalizations in 2020, 6,872 cases were diagnosed with sepsis based on the ASE (5.4% per year), and 893 patients were identified as having sepsis according to the International Classification of Diseases , 10th Edition (ICD-10) (0.7% per year). Hospital mortality rates were 16.6% (ASE) and 23.5% (ICD-10-coded sepsis). Monthly sepsis prevalence and hospital mortality exhibited less variation when diagnosed using ASE compared with ICD-10 coding (coefficient of variation [CV] for sepsis prevalence: 0.051 vs. 0.163, Miller test p < 0.001; CV for hospital mortality: 0.087 vs. 0.261, p = 0.001).</p><p><strong>Conclusions: </strong>ASE demonstrated high sensitivity and a moderate PPV compared with the Sepsis-3 criteria in a Korean population. The prevalence of sepsis, as defined by ASE, was 5.4% per year and was similar to U.S. estimates. The prevalence of sepsis by ASE was eight times higher and exhibited less monthly variability compared with that based on the ICD-10 code.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":7.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239092/pdf/","citationCount":"0","resultStr":"{\"title\":\"Validation of Adult Sepsis Event and Epidemiologic Analysis of Sepsis Prevalence and Mortality Using Adult Sepsis Event's Electronic Health Records-Based Sequential Organ Failure Assessment Criteria: A Single-Center Study in South Korea.\",\"authors\":\"Su Yeon Lee, Mi Hyeon Park, Dong Kyu Oh, Chae-Man Lim\",\"doi\":\"10.1097/CCM.0000000000006270\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>In 2018, the Centers for Disease Control and Prevention introduced the Adult Sepsis Event (ASE) definition, using electronic health records (EHRs) data for surveillance and sepsis quality improvement. However, data regarding ASE outside the United States remain limited. We therefore aimed to validate the diagnostic accuracy of the ASE and to assess the prevalence and mortality of sepsis using ASE.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>A single center in South Korea, with 2732 beds including 221 ICU beds.</p><p><strong>Patients: </strong>During the validation phase, adult patients who were hospitalized or visiting the emergency department between November 5 and November 11, 2019, were included. In the subsequent phase of epidemiologic analysis, we included adult patients who were admitted from January to December 2020.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>ASE had a sensitivity of 91.6%, a specificity of 98.3%, a positive predictive value (PPV) of 57.4%, and a negative predictive value of 99.8% when compared with the Sepsis-3 definition. Of 126,998 adult patient hospitalizations in 2020, 6,872 cases were diagnosed with sepsis based on the ASE (5.4% per year), and 893 patients were identified as having sepsis according to the International Classification of Diseases , 10th Edition (ICD-10) (0.7% per year). Hospital mortality rates were 16.6% (ASE) and 23.5% (ICD-10-coded sepsis). Monthly sepsis prevalence and hospital mortality exhibited less variation when diagnosed using ASE compared with ICD-10 coding (coefficient of variation [CV] for sepsis prevalence: 0.051 vs. 0.163, Miller test p < 0.001; CV for hospital mortality: 0.087 vs. 0.261, p = 0.001).</p><p><strong>Conclusions: </strong>ASE demonstrated high sensitivity and a moderate PPV compared with the Sepsis-3 criteria in a Korean population. The prevalence of sepsis, as defined by ASE, was 5.4% per year and was similar to U.S. estimates. 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引用次数: 0
摘要
目标：2018 年，美国疾病控制和预防中心推出了成人败血症事件（ASE）定义，利用电子健康记录（EHR）数据进行监测和败血症质量改进。然而，美国以外的 ASE 数据仍然有限。因此，我们旨在验证 ASE 的诊断准确性，并利用 ASE 评估败血症的患病率和死亡率：设计：回顾性队列研究：地点：韩国的一个中心，拥有2732张病床，其中包括221张ICU病床：在验证阶段，纳入了2019年11月5日至11月11日期间住院或到急诊科就诊的成年患者。在随后的流行病学分析阶段，我们纳入了2020年1月至12月住院的成年患者：测量和主要结果与败血症-3定义相比，ASE的敏感性为91.6%，特异性为98.3%，阳性预测值（PPV）为57.4%，阴性预测值为99.8%。在 2020 年住院的 126,998 名成人患者中，6,872 例根据 ASE 诊断为败血症（每年 5.4%），893 名患者根据《国际疾病分类》第 10 版（ICD-10）被确定为败血症（每年 0.7%）。医院死亡率为 16.6%（ASE）和 23.5%（ICD-10 编码败血症）。与 ICD-10 编码相比，采用 ASE 诊断的脓毒症月流行率和医院死亡率的变化较小（脓毒症流行率的变异系数 [CV] 为 0.051，而 ICD-10 的变异系数 [CV] 为 0.051：0.051 vs. 0.163，米勒检验 p <0.001；医院死亡率的变异系数：0.087 vs. 0.261，p = 0.001）：结论：在韩国人群中，与败血症-3标准相比，ASE显示出较高的灵敏度和适度的PPV。根据 ASE 的定义，败血症的患病率为每年 5.4%，与美国的估计值相似。与基于 ICD-10 编码的脓毒症患病率相比，ASE 的患病率高出八倍，且每月的变化较小。
Validation of Adult Sepsis Event and Epidemiologic Analysis of Sepsis Prevalence and Mortality Using Adult Sepsis Event's Electronic Health Records-Based Sequential Organ Failure Assessment Criteria: A Single-Center Study in South Korea.
Objectives: In 2018, the Centers for Disease Control and Prevention introduced the Adult Sepsis Event (ASE) definition, using electronic health records (EHRs) data for surveillance and sepsis quality improvement. However, data regarding ASE outside the United States remain limited. We therefore aimed to validate the diagnostic accuracy of the ASE and to assess the prevalence and mortality of sepsis using ASE.
Design: Retrospective cohort study.
Setting: A single center in South Korea, with 2732 beds including 221 ICU beds.
Patients: During the validation phase, adult patients who were hospitalized or visiting the emergency department between November 5 and November 11, 2019, were included. In the subsequent phase of epidemiologic analysis, we included adult patients who were admitted from January to December 2020.
Interventions: None.
Measurements and main results: ASE had a sensitivity of 91.6%, a specificity of 98.3%, a positive predictive value (PPV) of 57.4%, and a negative predictive value of 99.8% when compared with the Sepsis-3 definition. Of 126,998 adult patient hospitalizations in 2020, 6,872 cases were diagnosed with sepsis based on the ASE (5.4% per year), and 893 patients were identified as having sepsis according to the International Classification of Diseases , 10th Edition (ICD-10) (0.7% per year). Hospital mortality rates were 16.6% (ASE) and 23.5% (ICD-10-coded sepsis). Monthly sepsis prevalence and hospital mortality exhibited less variation when diagnosed using ASE compared with ICD-10 coding (coefficient of variation [CV] for sepsis prevalence: 0.051 vs. 0.163, Miller test p < 0.001; CV for hospital mortality: 0.087 vs. 0.261, p = 0.001).
Conclusions: ASE demonstrated high sensitivity and a moderate PPV compared with the Sepsis-3 criteria in a Korean population. The prevalence of sepsis, as defined by ASE, was 5.4% per year and was similar to U.S. estimates. The prevalence of sepsis by ASE was eight times higher and exhibited less monthly variability compared with that based on the ICD-10 code.
期刊介绍：
Critical Care Medicine is the premier peer-reviewed, scientific publication in critical care medicine. Directed to those specialists who treat patients in the ICU and CCU, including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals, Critical Care Medicine covers all aspects of acute and emergency care for the critically ill or injured patient.
Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.
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