Severe sepsis: Difference between revisions
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{{ICD10 category|Infectious disease}}{{ICD10 category|Cardiovascular}} | {{ICD10 category|Infectious disease}}{{ICD10 category|Cardiovascular}} | ||
== Additional Info == | == Additional Info == | ||
*Even though ICD-10 has not yet been modified to reflect it, | *Even though as of November 2017 ICD-10 has not yet been modified to reflect it, we are using the 2016 consensus definition of sepsis and septic shock (JAMA 315(8):801-10, 2016). These new definitions completely do away with talking about the Systemic Inflammatory Response Syndrome (SIRS). In the 2016 definitions we have just 2 subcategories: | ||
**Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis" | |||
**Sepsis | **Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone | ||
**Septic shock | *For these the cause is proven infection, OR '''presumed''' infection -- thus positive cultures are ''not'' required. | ||
*The 2016 consensus group defined the ORGAN DYSFUNCTION as an acute CHANGE from patient's baseline total SOFA score by >2 points -- where the baseline SOFA score can be assumed to be 0 in patients not known to have preexisting organ dysfunction. | |||
* | |||
*The 2016 consensus group defined the ORGAN DYSFUNCTION as | |||
*Here is the SOFA scoring: | *Here is the SOFA scoring: | ||
Revision as of 06:40, 2017 November 2
| ICD10 Diagnosis | |
| Dx: | Severe sepsis |
| ICD10 code: | R65.1 |
| Pre-ICD10 counterpart: | Severe Sepsis |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Sepsis |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- Even though as of November 2017 ICD-10 has not yet been modified to reflect it, we are using the 2016 consensus definition of sepsis and septic shock (JAMA 315(8):801-10, 2016). These new definitions completely do away with talking about the Systemic Inflammatory Response Syndrome (SIRS). In the 2016 definitions we have just 2 subcategories:
- Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis"
- Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
- For these the cause is proven infection, OR presumed infection -- thus positive cultures are not required.
- The 2016 consensus group defined the ORGAN DYSFUNCTION as an acute CHANGE from patient's baseline total SOFA score by >2 points -- where the baseline SOFA score can be assumed to be 0 in patients not known to have preexisting organ dysfunction.
- Here is the SOFA scoring:
- 0 1 2 3 4
- --------------------------------------------------------------------------------
- PaO2/FIO2 >=400 <400 <300 <200 <100
- Platelet count >=150 <150 <100 <50 <20
- Serum bilirubin (uM) <20 20-32 33-101 102-204 >204
- Cardiovascular MAP>=70 MAP<70
- GCS 15 13-14 10-12 6-9 <6
- Serum creatinine (uM) <110 110-170 171-299 300-440 >440
- Urine output (mL/day) <500 <200
Alternate ICD10s to consider coding instead or in addition
- Sepsis (SIRS due to infection, without acute organ failure)
- Severe sepsis
- Shock, septic
- Puerperal (post-delivery) infections or sepsis
- Shock, NOS
- Shock, cardiogenic
- Shock, hypovolemic shock or hemorrhagic shock
- Toxic shock syndrome
- Bacteremia, NOS AND Fungemia, NOS -- these are laboratory manifestations, and while it's OK to code them if present, if you do so you should also code the clinical manifestation (such as sepsis, etc).
Candidate Combined ICD10 codes
- Also code the causative infection.
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Show all ICD10 Subcategories