A disease-specific comorbidity index for predicting mortality in patients admitted to hospital with a cardiac condition.

A disease-specific comorbidity index for predicting mortality in patients admitted to hospital with a cardiac condition. CMAJ. 2019 Mar 18;191(11):E299-E307 Authors: Azzalini L, Chabot-Blanchet M, Southern DA, Nozza A, Wilton SB, Graham MM, Gravel GM, Bluteau JP, Rouleau JL, Guertin MC, Jolicoeur EM Abstract BACKGROUND: Comorbidity indexes derived from administrative databases are essential tools of research in global health. We sought to develop and validate a novel cardiac-specific comorbidity index, and to compare its accuracy with the generic Charlson-Deyo and Elixhauser comorbidity indexes. METHODS: We derived the cardiac-specific comorbidity index from consecutive patients who were admitted to hospital at a tertiary-care cardiology hospital in Quebec. We used logistic regression analysis and incorporated age, sex and 22 clinically relevant comorbidities to build the index. We compared the cardiac-specific comorbidity index with refitted Charlson-Deyo and Elixhauser comorbidity indexes using the C-statistic and net reclassification improvement to predict in-hospital death, and the Akaike information criterion to predict length of stay. We validated our findings externally in an independent cohort obtained from a provincial registry of coronary disease in Alberta. RESULTS: The novel cardiac-specific comorbidity index outperformed the refitted generic Charlson-Deyo and Elixhauser comorbidity indexes for predicting ...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research