Charlson Comorbidity Index Based On Hospital Episode Statistics Performs Adequately In Predicting Mortality, But Its Discriminative Ability Diminishes Over Time

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Pylväläinen , J , Talala , K , Murtola , T , Taari , K , Raitanen , J , Tammela , T L & Auvinen , A 2019 , ' Charlson Comorbidity Index Based On Hospital Episode Statistics Performs Adequately In Predicting Mortality, But Its Discriminative Ability Diminishes Over Time ' , Clinical Epidemiology , vol. 11 , pp. 923-932 . https://doi.org/10.2147/CLEP.S218697

Title: Charlson Comorbidity Index Based On Hospital Episode Statistics Performs Adequately In Predicting Mortality, But Its Discriminative Ability Diminishes Over Time
Author: Pylväläinen, Juho; Talala, Kirsi; Murtola, Teemu; Taari, Kimmo; Raitanen, Jani; Tammela, Teuvo L.; Auvinen, Anssi
Contributor: University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Abdominal Center
Date: 2019
Language: eng
Number of pages: 10
Belongs to series: Clinical Epidemiology
ISSN: 1179-1349
URI: http://hdl.handle.net/10138/306884
Abstract: Purpose: To evaluate the performance of Charlson Comorbidity Index (CCI) calculated using hospitalization and medication reimbursement databases in predicting mortality. Patients and methods: Information on hospitalizations was obtained from the national Care Register for Health Care (HILMO) and on medication reimbursements and entitlements for special reimbursements for medications from the Social Insurance Institution for 77,440 men aged 56-71 years at baseline. The subjects were followed up for mortality via Statistics Finland with 20,562 deaths during a 13-year follow-up. Results: Compared to a CCI score of 0, the age-adjusted hazard ratio for all-cause mortality associated with HILMO-based CCI scores of 1, 2 and 3 or more were 2.39 (95% CI 2.29-2.49), 2.96 (95% CI 2.81-3.13) and 6.42 (95% CI 5.95-6.93) at 13 years. The C-statistic was 0.72 at 1, 0.68 at 5 and 0.66 at 13 years, with only minor improvement over age alone (0.10, 0.06 and 0.04 accordingly). Addition of medication data did not improve predictive abilities and medication-based CCI performed poorly on its own. Conclusion: The hospitalization-based CCI, as well as that based on both databases, predicts relative mortality adequately, but its discriminative ability diminishes over time. Conditions related to hospitalizations affect survival more than medications.
Subject: mortality
comorbidity
follow-up studies
hospitalization/statistics and numerical data
drug prescriptions/statistics and numerical data
confounding factors
DEATH REGISTER DATA
DISCHARGE REGISTER
ADMINISTRATIVE DATA
VALIDITY
CARE
ADJUSTMENT
VALIDATION
ICD-9-CM
DISEASE
DIAGNOSES
3142 Public health care science, environmental and occupational health
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