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Discharge diagnoses versus medical record review in the identification of community-acquired sepsis

Overview of attention for article published in Critical Care, December 2015
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  • Good Attention Score compared to outputs of the same age (71st percentile)

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Discharge diagnoses versus medical record review in the identification of community-acquired sepsis
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0771-6
Pubmed ID

Henry E Wang, Dylan R Addis, John P Donnelly, Nathan I Shapiro, Russell L Griffin, Monika M Safford, John W Baddley


We evaluated the accuracy of hospital discharge diagnoses in the identification of community-acquired sepsis and severe sepsis. We reviewed 379 serious infection hospitalizations from 2003 to 2012 from the national population-based reasons for geographic and racial differences in stroke (REGARDS) cohort. Through manual review of medical records, we defined criterion-standard community-acquired sepsis events as the presence of a serious infection on hospital presentation with ≥2 systemic inflammatory response syndrome criteria. We also defined criterion-standard community-acquired severe sepsis events as sepsis with >1 sequential organ failure assessment organ dysfunction. For the same hospitalizations, we identified sepsis and severe sepsis events indicated by Martin et al. and Angus et al. International Classifications of Diseases 9th edition discharge diagnoses. We evaluated the diagnostic accuracy of the Martin and Angus criteria for detecting criterion-standard community-acquired sepsis and severe sepsis events. Among the 379 hospitalizations, there were 156 community-acquired sepsis and 122 community-acquired severe sepsis events. Discharge diagnoses identified 55 Martin-sepsis and 89 Angus-severe sepsis events. The accuracy of Martin-sepsis criteria for detecting community-acquired sepsis were: sensitivity 27.6%; specificity 94.6%; positive predictive value (PPV) 78.2%; negative predictive value (NPV) 65.1%. The accuracy of the Angus-severe sepsis criteria for detecting community-acquired severe sepsis were: sensitivity 42.6%; specificity 86.0%; PPV 58.4%; NPV 75.9%. Mortality was higher for Martin-sepsis than community-acquired sepsis (25.5% versus 10.3%, P = 0.006), as well as for Angus-severe sepsis than community-acquired severe sepsis (25.5 versus 11.5%, P = 0.002). Other baseline characteristics were similar between sepsis groups. Hospital discharge diagnoses show good specificity but poor sensitivity for detecting community-acquired sepsis and severe sepsis. While sharing similar baseline subject characteristics as cases identified by hospital record review, discharge diagnoses selected for higher mortality sepsis and severe sepsis cohorts. The epidemiology of a sepsis population may vary with the methods used for sepsis event identification.

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The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 4%
Malaysia 1 2%
Denmark 1 2%
Brazil 1 2%
Unknown 41 89%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 8 17%
Other 6 13%
Student > Master 6 13%
Student > Doctoral Student 4 9%
Student > Bachelor 2 4%
Other 9 20%
Unknown 11 24%
Readers by discipline Count As %
Medicine and Dentistry 24 52%
Agricultural and Biological Sciences 2 4%
Engineering 2 4%
Immunology and Microbiology 1 2%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 2 4%
Unknown 14 30%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 February 2015.
All research outputs
of 25,374,647 outputs
Outputs from Critical Care
of 6,554 outputs
Outputs of similar age
of 395,408 outputs
Outputs of similar age from Critical Care
of 466 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one is in the 35th percentile – i.e., 35% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 395,408 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 466 others from the same source and published within six weeks on either side of this one. This one is in the 20th percentile – i.e., 20% of its contemporaries scored the same or lower than it.