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ADDIN EN.CITE.DATA 12,17,18 Infection CategoryICD-9 CodeICD-9 Code DescriptionParasitic001Cholera002Typhoid/paratyphoid fever003Other salmonella infection004Shigellosis005Other food poisoning008Intestinal infections due to Escherichia coli008.1Intestinal infections due to Arizona group of paracolon bacillus008.2Intestinal infections due to Aerobacter aerogenes008.3Intestinal infections due to Proteus (mirabilis morganii)008.4Intestinal infections due to unspecified bacteria008.5Bacterial enteritis, unspecified009Ill-defined intestinal infection013CNS tuberculosis018Miliary tuberculosis020Plague021Tularemia022Anthrax023Brucellosis024Glanders025Melioidosis026Rat-bite fever027Other bacterial zoonoses032Diphtheria033Whooping cough034Streptococcal throat/scarlet fever035Erysipelas036Meningococcal infection037Tetanus038Septicemia039Actinomycotic infections040Other bacterial diseases041Bacterial infection in other diseases not specified098Gonococcal infections100Leptospirosis101Vincent’s angina112Candidiasis, of mouth112.4Candidiasis, of lung112.5Candidiasis, disseminatedAPPENDIX 1 (con’t)Infection CategoryICD-9 CodeICD-9 Code Description112.8Candidiasis, of other specified sites114Coccidioidomycosis115Histoplasmosis116Blastomycotic infection117Other mycoses118Opportunistic mycosesNervous320Bacterial meningitis321Cryptococcal meningitis321.1Meningitis in other fungal diseases324CNS abcess325Phlebitis of intracranial sinus360Purulent endophthalmitis376Acute inflammation of orbit380.14Malignant otitis externa383Acute mastoiditisCirculatory420.99Acute pericarditis due to other specified organisms421Acute or subacute endocarditisRespiratory461Acute sinusitis462Acute pharyngitis463Acute tonsillitis464Acute laryngitis/tracheitis465Acute upper respiratory infection of multiple sites/not otherwise specified475Peritonsillar abscess481Pneumococcal pneumonia482Other bacterial pneumonia485Bronchopneumonia with organism not otherwise specified486Pneumonia, organism not otherwise specified491.21Acute exacerbation of obstructive chronic bronchitis494Bronchiectasis510Empyema513Abscess of lung and mediastinumDigestive522.5Periapical abscess without sinus522.7Periapical abscess with sinus526.4Inflammatory conditions of the jaw527.3Abscess of the salivary glands528.3Cellulitis and abscess of oral soft tissue540Acute appendicitisAPPENDIX 1 (con’t)Infection CategoryICD-9 CodeICD-9 Code Description541Appendicitis not otherwise specified542Other appendicitis562.01Diverticulitis of the small intestine without hemorrhage562.03Diverticulitis of the small intestine with hemorrhage562.11Diverticulitis of colon without hemorrhage562.13Diverticulitis of colon with hemorrhage566Abscess of the anal and rectal regions567Peritonitis569.5Intestinal abscess569.61Infection of colostomy or enterostomy569.83Perforation of intestine572Abscess of liver572.1Portal pyemia575Acute cholecystitisGenitourinary590Kidney infection599Urinary tract infection not otherwise specified601Prostatic inflammation604Orchitis and epididymitis614Female pelvic inflammation disease615Uterine inflammatory disease616.3Abscess of Bartholin’s gland616.4Other abscess of vulvaPregnancy634Spontaneous abortion, complicated by genital tract and pelvic infection635Legally induced abortion, complicated by genital tract and pelvic infection636Illegally induced abortion, complicated by genital tract and pelvic infection637Unspecified abortion, complicated by genital tract and pelvic infection638Failed attempted abortion, complicated by genital tract and pelvic infection639Complications following abortion and ectopic and molar pregnancies 646.6Infections of genitourinary tract in pregnancy658.4Infection of amniotic cavity670Major puerperal infection675.1Abscess of breastSkin681Cellulitis, finger/toe682Other cellulitis or abscess683Acute lymphadenitis685Pilonidal cyst, with abscessAPPENDIX 1 (con’t)Infection CategoryICD-9 CodeICD-9 Code Description686Other local skin infectionMusculoskeletal711Pyogenic arthritis728.86Necrotizing fasciitis730OsteomyelitisOther790.7Bacteremia958.3Posttraumatic wound infection, not elsewhere classified996.6Infection or inflammation of device/graft998.5Postoperative infection999.3Infectious complication of medical care not otherwise classifiedAPPENDIX 2International Classification of Diseases, ninth edition (ICD-9) codes associated with organ dysfunction.PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5XYW5nPC9BdXRob3I+PFllYXI+MjAwNzwvWWVhcj48UmVj

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ADDIN EN.CITE.DATA 12,17,18 Organ Dysfunction CategoryICD-9 CodeICD-9 Code DescriptionCardiovascular458Orthostatic hypotension458.8Other specified hypotension458.9Hypotension, unspecified785.5Shock without mention of traumaHematologic286.6Defribrination syndrome286.8Other and unspecified coagulation defects287.4Secondary thrombocytopenia287.5Thrombocytopenia, unspecifiedHepatic570Acute and subacute necrosis of liver573.4Hepatic infarctionNeurologic293Transient organic psychosis348.1Anoxic brain damage348.3EncephalopathyRenal584Acute renal failureRespiratory518.8Respiratory Failure786.03Apnea799.1Respiratory ArrestAPPENDIX 3Characteristics of United States Emergency Department (ED) adult sepsis visits, 2009-2011. Includes age ≥18 years only. Sepsis classifications provided in Table 1. Infection or Organ DysfunctionOriginal ED SepsisAnnual N=665,319% (95% CI)qSOFA ED SepsisAnnual N=318,832 % (95% CI)Revised ED SepsisAnnual N=847,868% (95% CI)Infection98.8 (97.1-99.5)100.099.0 (97.8-99.6)Fever (triage body temperature >38 ?C or <36 ?C)44.8 (38.6-51.1)49.1 (41.2-57.1)45.5 (40.1-51.0)Serious Infection Diagnosis67.3 (61.0-73.1)70.7 (62.7-77.6)69.0 (63.5-74.0)Infectious/Parasitic Diseases 12.2 (8.8-16.7)16.5 (11.1-23.8)12.9 (9.9-16.7)Respiratory System Infections 31.7 (26.7-37.1)35.1 (28.2-42.7)33.9 (29.2-38.9)Digestive System Infections4.6 (2.9-7.2)*3.8 (1.7-8.2)*3.8 (2.4-5.9)*Genitourinary System Infections18.9 (15.2-23.4)19.6 (13.2-28.0)19.0 (15.3-23.4)Infectious Complications of Pregnancy, Childbirth, Puerperium0.8 (0.2-2.5)*1.4 (0.4-5.1)*1.2 (0.5-2.7)*Skin and Subcutaneous Tissue Infections3.3 (1.7-6.2)*2.5 (1.2-5.4)*3.3 (1.9-5.6)*Organ Dysfunction99.8 (99.4-100.0)100.099.9 (99.5-100.0)Organ Dysfunction Diagnosis Codes52.6 (46.5-58.6)14.2 (9.1-21.5)41.3 (35.9-46.8)Cardiovascular 13.5 (10.2-17.6)8.0 (4.4-14.0)*10.6 (8.1-13.8)Hematologic 5.1 (3.1-8.2)*1.3 (0.4-4.1)*4.0 (2.4-6.5)*Hepatic0.5 (0.1-1.5)*00.4 (0.1-1.1)*Neurologic3.6 (1.6-7.6)*02.8 (1.3-6.1)*Renal12.7 (8.9-17.9)3.1 (1.2-7.4)*10.0 (6.9-14.2) Pulmonary18.1 (14.1-22.8)2.4 (0.9-6.7)*14.2 (11.0-18.0)Endotracheal Intubation8.6 (6.0-12.1)4.2 (1.9-8.7)*6.7 (4.7-9.4)SBP ≤90 mmHg48.5 (42.6-54.5)32.7 (25.4-41.0)38.1 (32.9-43.5)≥2 qSOFA Criteria20.7 (16.7-25.4)100.037.8 (32.7-43.2)qSOFA Glasgow Coma Score (GCS ≤13)30.9 (22.2-41.2)76.5 (65.5-84.9)48.8 (40.0-57.8)qSOFA Respiratory (respiratory rate ≥22 breaths/min)31.3 (26.0-37.2)85.1 (78.7-89.8)43.4 (38.3-48.7)qSOFA Blood Pressure (systolic blood pressure ≤100 mmHg)52.3 (46.4-58.2)68.3 (59.2-76.2)53.2 (47.6-58.7)Diagnosis of Severe Sepsis or Septic Shock4.0 (2.5-6.5)*3.3 (1.3-7.8)*3.2 (1.9-5.1)*APPENDIX 4Characteristics of United States Emergency Department (ED) adult sepsis visits using different ED Sepsis classifications, 2009-2011. *Estimates based upon <30 raw observations. CharacteristicOriginal ED SepsisAnnual N= 665,319% (95% CI)qSOFA ED SepsisAnnual N=318,832 % (95% CI)Revised ED SepsisAnnual N= 847,868% (95% CI)Age18-24 6.1 (3.9-9.4)*3.1 (1.4-6.9)*5.8 (3.9-8.5)25-4411.0 (8.1-14.9)7.0 (4.1-11.6)*10.3 (7.8-13.6)45-6430.9 (25.9-36.5)29.5 (22.4-37.8)31.2 (26.5-36.4)65-7417.1 (12.7-22.7)23.7 (17.4-31.6)17.8 (13.9-22.4)≥75 34.8 (29.4-40.7)36.7 (28.8-45.4)35.0 (30.0-40.2)SexMale46.2 (40.8-51.7)47.9 (40.4-55.4)44.7 (40.2-49.3)Female53.8 (48.3-59.2)52.1 (44.6-59.6)55.3 (50.7-59.9)RaceWhite79.3 (73.8-83.8)81.4 (73.1-87.7)79.6 (74.5-84.0)Black17.4 (13.1-22.6)15.7 (10.3-23.1)17.2 (13.2-22.0)Other3.4 (1.8-6.2)*2.9 (1.1-7.4)*3.2 (1.8-5.7)*EthnicityHispanic6.7 (4.5-9.9)6.7 (3.9-11.2)*6.9 (4.9-9.7)Non-Hispanic93.3 (90.1-95.5)93.3 (88.8-96.1)93.1 (90.3-95.1)Arrival by EMSYes55.7 (49.4-61.8)64.9 (56.9-72.1)57.0 (51.8-62.0)No39.6 (33.6-46.0)31.3 (24.2-39.4)38.6 (33.7-43.8)Unknown4.7 (2.2-9.5)*3.8 (1.5-9.7)*4.4 (2.3-8.3)*Hospital Geographic RegionNortheast19.3 (13.0-27.6)15.7 (9.4-25.0)18.4 (12.2-26.7)Midwest25.4 (17.9-34.7)24.3 (15.9-35.2)23.7 (16.8-32.2)South37.4 (28.9-46.9)39.6 (28.5-52.0)38.4 (29.9-47.7)West17.9 (12.1-25.7)20.4 (13.0-30.6)19.6 (13.5-27.5)Patient Residence Population SettingMSA82.4 (70.6-90.1)78.6 (65.2-87.8)81.6 (70.0-89.3)Non-MSA17.6 (9.9-29.4)21.4 (12.2-34.8)18.4 (10.7-30.0)Arrival TimeDay (0700-1459)48.2 (42.9-53.5)49.0 (40.7-57.3)48.7 (43.8-53.6)Evening (1500-2259)35.9 (30.4-41.8)34.7 (27.5-42.8)35.2 (30.4-40.3)Night (2300-0659)15.9 (12.6-19.7)16.3 (11.9-22.0)16.1 (13.3-19.5)Patient Seen in ED in Last 72 HoursYes4.4 (2.6-7.3)*3.2 (1.5-6.8)*4.3 (2.6-6.9)No78.9 (71.6-84.8)84.7 (76.8-90.2)80.9 (74.4-86.0)Unknown16.7 (11.3-23.9)12.1 (7.2-19.8)*14.9 (10.1-21.3)Prior Medical HistoryStroke12.3 (8.5-17.4)11.0 (6.5-18.0)*11.0 (7.8-15.2)Congestive Heart Failure17.9 (13.9-22.8)15.0 (10.1-21.7)17.1 (13.5-21.3)Dialysis6.5 (3.7-11.1)*6.3 (3.4-11.3)*6.2 (3.7-10.0)HIV1.0 (0.3-2.9)*1.5 (0.3-7.4)*1.3 (0.5-3.4)*Diabetes25.8 (20.7-31.6)20.4 (14.4-28.1)23.6 (19.4-28.4)Triage Pulse0-40 bpm0.3 (0.1-1.0)*00.2 (0.1-0.7)*41-8033.1 (28.0-38.6)24.8 (18.2-32.9)31.2 (26.7-36.0)81-12049.9 (44.3-55.5)51.8 (43.7-59.7)52.0 (47.0-57.0)≥12014.0 (10.7-18.0)21.5 (15.9-28.4)13.9 (11.1-17.1)Unknown2.8 (1.6-5.0)*1.9 (0.7-4.9)*2.8 (1.6-4.8)*Triage Respiratory Rate0-6 breaths/min0.5 (0.1-1.6)*00.4 (0.1-1.3)*7-124.2 (2.5-7.1)*1.9 (0.6-6.5)*3.4 (2.0-5.6)*13-2059.0 (53.3-64.6)12.5 (8.1-18.7)*48.7 (43.5-54.0)21-3027.2 (22.2-32.8)75.0 (68.0-80.9)37.9 (32.9-43.1)>304.6 (3.0-6.9)10.1 (6.5-15.3)*5.9 (4.2-8.2)Unknown4.5 (2.8-7.3)*0.5 (0.1-3.5)*3.8 (2.4-5.9)*Triage Systolic Blood Pressure0-80 mmHg13.2 (10.1-16.9)14.7 (9.9-21.4)10.3 (8.0-13.2)81-10039.2 (33.3-45.4)53.6 (45.7-61.3)42.9 (37.6-48.3)101-12014.6 (10.9-19.4)11.6 (6.1-21.2)*15.0 (11.3-19.7)≥12030.2 (25.4-35.6)20.0 (14.7-26.8)29.6 (25.0-34.6)Unknown2.8 (1.5-5.4)*02.2 (1.1-4.3)*Length of ED Stay0-2 hours14.2 (11.0-18.1)12.0 (7.3-19.2)13.0 (10.2-16.5)>2-4 32.1 (26.3-38.4)35.7 (28.4-43.6)*31.8 (26.7-37.4)>4-8 40.9 (35.3-46.7)37.9 (30.7-45.8)41.6 (36.5-46.9)>8 9.5 (6.7-13.5)11.2 (6.7-18.2)*10.6 (7.7-14.3)Unknown3.4 (1.8-6.3)*3.2 (1.6-6.5)*3.1 (1.7-5.4)*APPENDIX 5Adult Emergency Department (ED) sepsis visit outcomes, stratified by sepsis classification patterns, 2009-2011. *Estimates based upon <30 raw observations.OutcomeqSOFA Yes / Original NoAnnual N=182,549qSOFA No /Original YesAnnual N=529,036qSOFA Yes /Original YesAnnual N=136,283p-value% (95% CI)% (95% CI)% (95% CI)ED DispositionDischarged Home27.7 (18.4-39.4)27.5 (21.2-34.9)14.4 (6.5-29.0)*0.04Admitted: Non-ICU52.4 (40.1-64.5)43.2 (35.8-50.9)40.1 (27.7-54.0)Admitted: ICU19.9 (12.2-30.7)*29.3 (23.7-35.7)45.4 (32.3-59.2)MortalityOverall Death7.4 (3.3-16.0)*11.5 (8.1-16.2)12.6 (7.3-20.8)*0.47 ................
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