Last modified: 2017-10-08
Abstract
Introduction
There is no study on degree of diagnosis agreement among three established sepsis diagnosis criteria as a basis of necessity to further studied the best diagnosis criteria to diagnose infected patient with sepsis in Indonesia. We investigated the degree of diagnosis agreement among these three sepsis criteria.
Methods
A cross sectional study of adult Emergency Room patients hospitalized with diagnosis of infection in Cipto Mangunkusumo Hospital, Indonesia was conducted during March-April 2017. We recorded diagnosis, gender, age, comorbidities, infection source and origin. Every subjects was classified into sepsis and non-sepsis based on 1991, 2001 and sepsis-3 criteria. Raw % and Kappa agreement coefficients (κ) were calculated according to previous established formula to measure degree of agreement among three diagnosis criteria.
Results
As many as 278 subjects were included in this study. The raw % agreement and κ between 1991 and 2001 criteria is 69.07% and 0.34 respectively. The raw % agreement and κ between 2001 and sepsis-3 criteria is 56.12% and 0.15 respectively. The raw % agreement and κ between 1991 and sepsis-3 criteria is 48.19% and -0.02.
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Conclusions
There is fair agreement between 1991 and 2001 criteria, poor agreement between 2001 and sepsis-3 criteria, and poor disagreement between 1991 and sepsis-3 criteria, necessitates further Indonesian study of the best diagnosis criteria to diagnose infected patient with sepsis.
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Key words: degree of agreement, diagnosis criteria, sepsis