title: Relationship between death and infections among patients hospitalized in internal medicine departments: a prevalence and validation study.
abstract: BACKGROUND
  We assessed the burden of infection-related death at internal medicine departments in Denmark and the validity of 2 population-based registries for diagnoses of infection.
  
  
  METHODS
  We reviewed medical records of all inpatients who died at a large university hospital during 2008 with an infection diagnosis in the Cause of Death Registry (CDR) or Hospital Discharge Registry (HDR). We computed the positive predictive value of infection diagnoses and completeness of each registry with 95% confidence intervals (CIs) and the prevalence of infection-related deaths by capture-recapture analysis.
  
  
  RESULTS
  Among 458 deaths, 193 patients (42.1%) had an infection diagnosis of which 40.0% (183 out of 458) were verified. The positive predictive value of an infection diagnosis was 96.0% (95% CI, 92.0%-98.3%) in the CDR and 95.3% (CI, 90.9%-97.9%) in the HDR. Completeness of the CDR was 79.2% (CI, 72.9%-84.6%) and completeness of the HDR was 77.0% (CI, 70.6%-82.7%). By capture-recapture analysis we estimated that 43.2% of all deaths (198 out of 458) were related to infection.
  
  
  CONCLUSIONS
  The large proportion of deaths in internal medicine departments that are related to infection emphasizes the need for optimized infection prevention and treatment strategies. CDR and HDR are valid sources for identifying infection and may supplement each other for increased completeness of infection-related death in epidemiologic research.
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Boisen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Dalager-Pedersen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Søgaard
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Mortensen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: rwt@dce.au.dk.
authors.forename: Reimar W
authors.initials: RW
authors.lastname: Thomsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology* / Q000401:mortality*; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
keywords: Bacterial infections and mycoses; Cause of death/vital statistics; Epidemiology; Infectious disease medicine