Stroke: the Elixhauser Index for comorbidity adjustment of in-hospital case fatality.
BACKGROUND: Adjustment for comorbidity is an important component of any clinical outcome study using administrative data. The Elixhauser Index is a relatively newer comorbidity index for use with administrative data and has not been used to assess prognosis in patients with stroke. Similarly, an Int...
| Publicado en: | Neurology Vol. 71; no. 4; pp. 283 - 288 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
7/22/2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105662256&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105662256 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283878 NRO jtl: Neurology issn: 00283878 maglogo: N pubinfo: dt: 7/22/2008 vid: 71 iid: 4 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105662256 105662256 2009994403 10.1212/01.wnl.0000318278.41347.94 NLM18645167 105662256 ppf: 283 ppct: 5 formats: tig: atl: Stroke: the Elixhauser Index for comorbidity adjustment of in-hospital case fatality. aug: au: Zhu H Hill MD affil: Department of Clinical Neurosciences, University of Calgary, Foothills Hospital, Rm 1242A, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9. sug: subj: Comorbidity Inpatients Stroke Canada Chi Square Test Data Analysis Software Funding Source Logistic Regression Multivariate Analysis Stroke Mortality World Wide Web Human ab: BACKGROUND: Adjustment for comorbidity is an important component of any clinical outcome study using administrative data. The Elixhauser Index is a relatively newer comorbidity index for use with administrative data and has not been used to assess prognosis in patients with stroke. Similarly, an International Classification of Diseases (ICD)-10 coding algorithm has been rarely reported for Elixhauser Index. OBJECTIVE: To evaluate whether the Elixhauser Index provides a useful comorbidity adjustment for predicting in-hospital case-fatality in stroke outcome studies and to compare the degree of consistency using ICD-9-CM and ICD-10 coding algorithms. METHODS: Patients who had stroke from 1998 to 2000 (cohort A in the ICD-9-CM data) and 2003 to 2005 (cohort B in the ICD-10 data) in a large Canadian city were identified from the Hospital Discharge database. The performance of two coding algorithms for predicting the in-hospital case-fatality was assessed using multivariable logistic regression models. The C-statistic was used to compare the performance of each coding algorithm in predicting in-hospital case-fatality. RESULTS: Among 2,465 patients with stroke in the ICD-9-CM data (cohort A) and 2,987 patients with stroke in the ICD-10 data (cohort B), there was no difference in model performance using ICD-9-CM (C-statistic was 0.717) as compared with ICD-10 coding algorithms (C-statistic was 0.721; p = 0.83). Elixhauser comorbidity adjustment provided a better prediction of in-hospital case-fatality compared to reduced models including only age and gender (p < 0.0001) for both coding models. CONCLUSION: The Elixhauser Index provides similar comorbidity adjusted risk estimates using both ICD-9-CM and ICD-10, and may be useful for predicting risk-adjusted in-hospital case-fatality in stroke outcome studies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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