Attribution of infections
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Additional info
- Some of our reports "attribute" infections to units on which they happen if they are an Acquired Diagnosis.
Diagnoses with specific attribution rules
We have specific attribution rules as documented in their pages for the following diagnoses:
- Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
- Pneumonia, ventilator-associated (VAP)
- Iatrogenic, infection, urinary catheter
- Template:ICD10 Guideline Iatrogenic deals with attribution of surgical infections
- Nosocomial infection, NOS
- Template:ICD10 Guideline Como vs Admit - also deals with this
Attribution for all other infections
- There is usually a delay between the start of an actual infection and the time at which the infection is confirmed by the lab, or manifests so it can be determined without lab clarification (for diagnoses where we allow that).
- But except for the infections listed above which have specific attribution rules, we designate the START/ONSET of an infection as:
- When it is first noticed clinically, or was first identified by the lab -- whichever happens FIRST
- A chronic-type infection (e.g. TB) which is first discovered in hospital BUT presumably was actually present on admission is governed by the rules of Template:ICD10 Guideline Como vs Admit -- i.e. coded as an Admit Diagnosis.
- But rarely, a person can acquire such a chronic-type infection in hospital, and if THAT is thought to have happened, then code it as an Acquired Diagnosis.
- For an acute-type infection (e.g. bacterial cellulitis) first identified after admission (the start of the current PatientFollow Project profile) to choose Admit Diagnosis vs. Comorbid Diagnosis, you should try to figure out whether it was actually present at admission or actually began after admission.
- Typically there will be at least a guess by the team about this. If not, then you can default to the guideline that if it was first discovered within the first 48 hrs after admission to code it as an Admit Diagnosis, and if discovered >48 hrs after admission to code it as as an Acquired Diagnosis.
Attribution doesn't apply to colonization
See Colonized with organism (not infected)#Colonizations are not attributed to any units