Quality Transparency Dashboard
Sepsis Mortality Calculation

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Quality Transparency Dashboard Sepsis Mortality Calculation (Update Sep 2019)

How does HQI calculate sepsis mortality?  (ICD-10-CM)

ICD-10-CM Codes used to identify sepsis cases and calculate the sepsis in-hospital mortality rate for inpatient discharges as presented in the Quality Transparency Dashboard.  While sepsis is diagnosed, based on codes, it is not strictly the identified cause of death. The modified Dombrovskiy Method for sepsis case identification follows this process:

  1. Identify all cases with a diagnosis code (in any position) for septicemia or sepsis
  2. Identify all cases with a diagnosis code (in any position) for organ dysfunction
  3. Identify cases with a code in both #1 and #2 as sepsis cases
  4. Determine percentage of sepsis cases in which discharge disposition of patient is “expired”

 ”pseudo” code: 

ARRAY dx{*} diag_p odiag1-odiag24;

            DO J=1 to 25;

ICD-10 Septicemia:

IF DX{j} in

(‘A021′ ‘A207′ ‘A217′ ‘A227′ ‘A267′ ‘A327′ ‘A391′ ‘A392′ ‘A393′ ‘A394′ ‘A400′ ‘A401′ ‘A403′ ‘A408′ ‘A409′ ‘A4101′ ‘A4102′ ‘A411′ ‘A412′ ‘A413′ ‘A414′ ‘A4150′ ‘A4151′ ‘A4152′ ‘A4153′ ‘A4159′ ‘A4181′ ‘A4189′ ‘A419′ ‘A427′ ‘A5486′ ‘B007′ ‘B377′ ‘O0337′ ‘O0387′ ‘O0487′ ‘O0737′ ‘O0882′ ‘O85′ ‘P360′ ‘P3610′ ‘P3619′ ‘P362′ ‘P3630′ ‘P3639′ ‘P364′ ‘P365′ ‘P368′ ‘P369′ ‘R6520′ ‘R6521′ ‘T8112XA’ ‘T8112XD’ ‘T8112XS’ ‘I2601′ ‘I2690′ ‘I76′ ‘O8604′ ‘O8609′ ‘O8681′ ‘O88311′ ‘O88312′ ‘O88313′ ‘O88319′ ‘O8832′ ‘O8833′ ‘T8144XA’ ‘T8144XD’ ‘T8144XS’)

[comment: codes in boldface above added Sep 2019]

then septicemia=1;

ICD-10 Organ Dysfunction:

IF DX{j} in

(‘A391′ ‘D65′ ‘D6959′ ‘D696′ ‘D698′ ‘D699′ ‘E872′ ‘E874′ ‘F05′ ‘F060′ ‘F061′ ‘F062′ ‘G6281′ ‘G7281′ ‘G9340′ ‘G9341′ ‘G9349′ ‘G936′ ‘G9382′ ‘G939′ ‘I468′ ‘I469′ ‘I951′ ‘I9589′ ‘I959′ ‘J80′ ‘J9600′ ‘J9601′ ‘J9602′ ‘J9620′ ‘J9621′ ‘J9622′ ‘J9690′ ‘J9691′ ‘J9692′ ‘J9801′ ‘J989′ ‘J99′ ‘K7200′ ‘K7201′ ‘K7290′ ‘K7291′ ‘K762′ ‘K763′ ‘K767′ ‘N170′ ‘N171′ ‘N172′ ‘N178′ ‘N179′ ‘N19′ ‘R000′ ‘R001′ ‘R031′ ‘R060′ ‘R0600′ ‘R0603′ ‘R0609′ ‘R0682′ ‘R0689′ ‘R0902′ ‘R092′ ‘R400′ ‘R401′ ‘R402110′ ‘R402111′ ‘R402112′ ‘R402113′ ‘R402114′ ‘R402120′ ‘R402121′ ‘R402122′ ‘R402123′ ‘R402124′ ‘R402130′ ‘R402131′ ‘R402132′ ‘R402133′ ‘R402134′ ‘R402210′ ‘R402211′ ‘R402212′ ‘R402213′ ‘R402214′ ‘R402220′ ‘R402221′ ‘R402222′ ‘R402223′ ‘R402224′ ‘R402230′ ‘R402231′ ‘R402232′ ‘R402233′ ‘R402234′ ‘R402240′ ‘R402241′ ‘R402242′ ‘R402243′ ‘R402244′ ‘R402310′ ‘R402311′ ‘R402312′ ‘R402313′ ‘R402314′ ‘R402320′ ‘R402321′ ‘R402322′ ‘R402323′ ‘R402324′ ‘R402330′ ‘R402331′ ‘R402332′ ‘R402333′ ‘R402334′ ‘R402340′ ‘R402341′ ‘R402342′ ‘R402343′ ‘R402344′ ‘R402350′ ‘R402351′ ‘R402352′ ‘R402353′ ‘R402354′ ‘R402420′ ‘R402421′ ‘R402422′ ‘R402423′ ‘R402424′ ‘R402430′ ‘R402431′ ‘R402432′ ‘R402433′ ‘R402434′ ‘R402440′ ‘R402441′ ‘R402442′ ‘R402443′ ‘R402444′ ‘R403′ ‘R570′ ‘R571′ ‘R578′ ‘R579′ ‘R6520′ ‘R6521′ ‘T8112XA’ ‘T8112XD’ ‘T8112XS’)

then dysfunction=1;

                  IF septicemia=1 AND dysfunction=1 THEN severesepsis=1;

How does HQI calculate sepsis mortality?  (ICD-9-CM)

ICD-9-CM Codes used to identify sepsis cases and calculate the sepsis in-hospital mortality rate for inpatient discharges as presented in the Quality Transparency Dashboard.  While sepsis is diagnosed, based on codes, it is not strictly the identified cause of death. The modified Dombrovskiy Method for sepsis case identification follows this process:

  1. Identify all cases with a diagnosis code (in any position) for septicemia or sepsis
  2. Identify all cases with a diagnosis code (in any position) for organ dysfunction
  3. Identify cases with a code in both #1 and #2 as sepsis cases
  4. Determine percentage of sepsis cases in which discharge disposition of patient is “expired”

 ”pseudo” code: 

     ARRAY dx{*} diag_p odiag1-odiag24;

            DO J=1 to 25 ;

ICD-9 Septicemia:

IF DX{j} in

(‘0031′ ‘0202′ ‘0223′ ‘0362′ ‘0363′ ‘0380′ ‘03810′ ‘03811′ ‘03812′ ‘03819′ ‘0382′ ‘0383′ ‘03840′ ‘03841′ ‘03842′ ‘03843′ ‘03844′ ‘03849′ ‘0388′ ‘0389′ ‘0545′ ‘1125′ ‘65930′ ‘65931′ ‘65933′ ‘67020′ ‘67022′ ‘67024′  ’77181′ ‘78552′ ‘99591′ ‘99592′ ‘99802′)

then septicemia=1;

ICD-9 Organ Dysfunction:

IF DX{j} in

(‘0363′ ‘2762′ ‘2866′ ‘2869′ ‘2874′ ‘28749′ ‘2875′ ‘2930′ ‘3481′ ‘34830′ ‘34831′ ‘34839′ ‘35782′ ‘35981′ ‘4275′ ‘4580′ ‘4588′ ‘4589′ ‘5185′ ‘51851′ ‘51852′ ‘51853′ ‘51881′ ‘51882′ ‘570′ ‘5722′ ‘5734′ ‘5800′ ‘5804′ ‘58081′ ‘58089′ ‘5809′ ‘5845′ ‘5846′ ‘5847′ ‘5848′ ‘5849′ ‘78001′ ‘78550′ ‘78551′ ‘78552′ ‘78559′ ‘78609′ ‘7963′ ‘7991′ ‘99592′ ‘99802′)

then dysfunction=1;

      IF septicemia=1 AND dysfunction=1 THEN severesepsis=1;