The impact of changes in coding on mortality reports using the example of sepsis

Atkin, Catherine; Pankhurst, Tanya; McNulty, David; Keogh, Ann; Gallier, Suzy; Pagano, Domenico; Sapey, Elizabeth; Ball, Simon

doi:10.1186/s12911-022-01947-x

BMC Medical Informatics and Decision Making

Table 2 Demographics of patients with a recorded diagnosis of septicaemia

From: The impact of changes in coding on mortality reports using the example of sepsis

Time period	April 2016–March 2017						April 2017–March 2018						April 2018–March 2019
Place in coding	Primary		Secondary		Any position		Primary		Secondary		Any position		Primary		Secondary		Any position
Place in coding	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Age
18–24	1345	1.9	4330	3.4	5675	2.9	2925	1.6	4885	3.8	7810	2.5	2095	1.6	5695	3.7	7790	2.7
25–44	5315	7.4	14,830	11.6	20,145	10.1	12,070	6.7	16,730	12.6	28,800	9.2	9250	6.8	20,200	13.0	29,450	10.1
45–59	11,055	15.5	20,400	15.9	31,455	15.8	24,545	13.7	21,965	16.5	46,510	14.9	19,685	14.6	25,365	16.3	45,050	15.5
60–69	13,735	19.2	21,985	17.2	35,720	17.9	31,210	17.4	22,800	17.1	54,010	17.3	24,225	17.9	26,470	17.0	50,695	17.4
70–79	17,775	24.9	28,825	22.5	46,600	23.4	45,560	25.3	29,420	22.2	74,980	24.0	35,270	26.1	35,090	22.5	70,360	24.2
80–89	16,935	23.7	28,935	22.6	45,870	23.0	48,420	26.9	28,650	21.5	77,070	24.6	34,360	25.4	33,270	21.3	67,630	23.2
90 +	5240	7.3	8685	6.8	13,925	7.0	15,030	8.4	8565	6.4	23,595	7.5	10,255	7.6	9880	6.3	20,135	6.9
Sex
Female	35,650	49.9	64,590	50.5	100,240	50.3	87,075	48.4	67,260	50.6	154,335	49.3	63,945	47.3	77,295	49.6	141,240	48.5
Male	35,755	50.1	63,395	49.5	99,150	49.7	92,690	51.6	65,760	49.4	158,450	50.7	71,200	52.7	78,665	50.4	149,865	51.5
Ethnicity
White	61,045	85.5	106,365	83.1	167,410	84.0	154,015	85.7	108,080	81.3	262,095	83.8	113,815	84.2	125,950	80.8	239,765	82.4
Asian/Asian British	2835	4.0	6580	5.1	9415	4.7	7235	4.0	6885	5.2	14,120	4.5	6005	4.4	8700	5.6	14,705	5.1
Black/Black British	1290	1.8	3050	2.4	4340	2.2	2780	1.6	3610	2.7	6390	2.0	2565	1.9	4075	2.6	6640	2.3
Mixed	365	0.4	600	0.5	865	0.4	700	0.4	705	0.5	1450	0.5	585	0.4	880	0.6	1465	0.5
Other ethnic groups	4785	6.7	8670	6.8	13,455	6.7	11,730	6.5	10,230	7.7	21,960	7.0	9450	7.0	12,485	8.0	21,935	7.5
Unknown	1185	1.7	2720	2.1	3905	2.0	3310	1.8	3505	2.6	6815	2.2	2720	2.0	3870	2.5	6590	2.3
IMD quintile
1 (lowest)	13,005	18.2	19,745	15.4	32,750	16.4	30,935	17.2	20,705	15.6	51,640	16.5	22,970	17.0	25,240	16.2	48,210	16.6
2	14,220	19.9	23,055	18.0	37,275	18.7	34,710	19.3	23,920	18.0	58,630	18.7	25,990	19.2	29,120	18.7	55,110	18.9
3	14,770	20.7	25,185	19.7	39,955	20.0	36,650	20.4	26,090	19.6	62,740	20.1	27,200	20.1	30,640	19.7	57,840	19.9
4	14,530	20.4	27,495	21.5	42,025	21.1	37,280	20.7	28,860	21.7	66,140	21.2	28,090	20.8	32,890	21.1	60,980	21.0
5 (highest)	14,355	20.1	31,170	24.4	45,525	22.8	38,710	21.5	32,020	24.1	70,730	22.6	29,685	22.0	36,000	23.1	65,685	22.6
Unknown	520	0.7	1335	1.0	1855	0.9	1485	0.8	1425	1.1	2910	0.9	1205	0.9	2075	1.3	3280	1.1
Admission type
Emergency	68,210	95.5	105,780	82.7	173,990	87.3	173,615	96.6	104,340	78.4	277,955	88.9	130,315	96.4	123,640	79.3	253,950	87.2
Non-emergency	3190	4.5	22,205	17.4	25,395	12.7	6150	3.4	28,680	21.6	34,830	11.1	4835	3.6	32,325	20.7	37,160	12.8

Time period	April 2019–March 2020						Odds ratio for sepsis recorded in primary position (compared to 2016/17)
Place in coding	Primary		Secondary		Any position		2017/18	2018/19	2019/20
Place in coding	N	%	N	%	N	%	OR (95% CI)	OR (95% CI)	OR (95% CI)
Age
18–24	1770	1.4	5150	3.3	6920	2.5	1.93 (1.78–2.08)	1.18 (1.09–1.28)	1.11 (1.02–1.20)
25–44	8265	6.7	19,885	12.8	28,150	10.1	2.01 (1.93–2.09)	1.28 (1.23–1.33)	1.16 (1.11–1.20)
45–59	17,425	14.2	25,110	16.2	42,535	15.3	2.06 (2.00–2.12)	1.43 (1.39–1.48)	1.28 (1.24–1.32)
60–69	21,345	17.4	26,100	16.8	47,445	17.1	2.19 (2.13–2.25)	1.47 (1.43–1.51)	1.31 (1.27–1.35)
70–79	32,865	26.8	36,000	23.2	68,865	24.8	2.51 (2.45–2.57)	1.63 (1.59–1.67)	1.48 (1.45–1.52)
80–89	31,730	25.8	33,240	21.4	64,970	23.4	2.89 (2.82–2.96)	1.76 (1.72–1.81)	1.63 (1.59–1.67)
90 +	9480	7.7	9915	6.4	19,395	7.0	2.91 (2.79–3.04)	1.72 (1.65–1.80)	1.58 (1.52–1.66)
Sex
Female	57,530	46.8	76,975	49.5	134,505	48.3	2.35 (2.31–2.38)	1.50 (1.47–1.52)	1.35 (1.33–1.38)
Male	65,355	53.2	78,425	50.5	143,780	51.7	2.50 (2.46–2.54)	1.61 (1.58–1.63)	1.48 (1.45–1.50)
Ethnicity
White	102,425	84.4	124,150	79.9	226,575	81.4	2.48 (2.45–2.51)	1.57 (1.55–1.59)	1.44 (1.42–1.46)
Asian/Asian British	5265	4.3	8960	5.8	14,225	5.1	2.44 (2.31–2.58)	1.60 (1.52–1.69)	1.36 (1.29–1.44)
Black/Black British	2465	2.0	3810	2.5	6275	2.3	1.82 (1.67–1.98)	1.49 (1.37–1.62)	1.53 (1.41–1.66)
Mixed	540	0.4	895	0.6	1435	0.5	1.63 (1.38–1.93)	1.09 (0.92–1.29)	0.99 (0.84–1.17)
Other ethnic groups	9250	7.5	13,570	8.7	22,820	8.2	2.08 (1.98–2.17)	1.37 (1.31–1.43)	1.24 (1.18–1.29)
Unknown	2930	2.4	4015	2.6	6945	2.5	2.17 (1.99–2.36)	1.61 (1.48–1.75)	1.68 (1.54–1.82)
IMD quintile
1 (lowest)	20,590	16.8	24,700	15.9	45,290	16.3	2.27 (2.20–2.33)	1.38 (1.34–1.42)	1.27 (1.23–1.30)
2	23,770	19.3	28,480	18.3	52,250	18.8	2.35 (2.29–2.42)	1.45 (1.41–1.49)	1.35 (1.32–1.39)
3	24,815	20.2	30,990	19.9	55,805	20.1	2.40 (2.33–2.46)	1.51 (1.47–1.55)	1.37 (1.33–1.40)
4	25,110	20.4	32,520	20.9	57,630	20.7	2.44 (2.38–2.51)	1.62 (1.58–1.66)	1.46 (1.42–1.50)
5 (highest)	26,590	21.6	35,560	22.9	62,150	22.3	2.63 (2.56–2.69)	1.79 (1.75–1.84)	1.62 (1.58–1.67)
Unknown	2005	1.6	3145	2.0	5150	1.9	2.68 (2.36–3.03)	1.49 (1.32–1.69)	1.64 (1.46–1.84)
Admission type
Emergency	118,710	96.9	122,800	79.0	241,510	86.8	2.58 (2.55–2.61)	1.63 (1.61–1.65)	1.50 (1.48–1.52)
Non-emergency	4175	3.4	32,600	21.0	36,775	13.2	1.49 (1.43–1.56)	1.04 (0.99–1.09)	0.89 (0.85–0.94)

IMD Index of Multiple Deprivation quintile. Percentages refer to percentage within the column; row percentages not shown. Odds ratio for recording of sepsis in primary position for those where sepsis recorded in diagnosis, compared to April 2016–March 2017. Data has been rounded for reporting

Back to article page

ISSN: 1472-6947

Contact us

General enquiries: journalsubmissions@springernature.com