医学
逻辑回归
ICD-10号
置信区间
共病
索引(排版)
队列
人口
急诊医学
队列研究
统计
人口学
查尔森共病指数
内科学
环境卫生
精神科
数学
计算机科学
社会学
万维网
作者
Marc Simard,Caroline Sirois,Bernard Candas
出处
期刊:Medical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2018-05-01
卷期号:56 (5): 441-447
被引量:134
标识
DOI:10.1097/mlr.0000000000000905
摘要
Objectives: To validate and compare performance of an International Classification of Diseases, tenth revision (ICD-10) version of a combined comorbidity index merging conditions of Charlson and Elixhauser measures against individual measures in the prediction of 30-day mortality. To select a weight derivation method providing optimal performance across ICD-9 and ICD-10 coding systems. Research Design: Using 2 adult population-based cohorts of patients with hospital admissions in ICD-9 (2005, n=337,367) and ICD-10 (2011, n=348,820), we validated a combined comorbidity index by predicting 30-day mortality with logistic regression. To appreciate performance of the Combined index and both individual measures, factors impacting indices performance such as population characteristics and weight derivation methods were accounted for. We applied 3 scoring methods (Van Walraven, Schneeweiss, and Charlson) and determined which provides best predictive values. Results: Combined index [ c -statistics: 0.853 (95% confidence interval: CI, 0.848–0.856)] performed better than original Charlson [0.841 (95% CI, 0.835–0.844)] or Elixhauser [0.841 (95% CI, 0.837–0.844)] measures on ICD-10 cohort. All weight derivation methods provided close high discrimination results for the Combined index (Van Walraven: 0.852, Schneeweiss: 0.851, Charlson: 0.849). Results were consistent across both coding systems. Conclusions: The Combined index remains valid with both ICD-9 and ICD-10 coding systems and the 3 weight derivation methods evaluated provided consistent high performance across those coding systems.
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