S-H Jang1, J-W Chea, K-B Lee. 1. Division of Nephrology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
AIMS: Mortality risks in ESRD (end stage renal disease) patients are related to comorbid diseases. The Charlson Comorbidity Index (CCI) has been reported to be a strong predictor of survival in incipient ESRD patients. The authors studied the validity of CCI using administrative database according to International Classification of Disease, 10th revision (ICD-10) codes, to devise a more straightforward method of determining CCI than that based on medical records review. SUBJECTS AND METHODS: Incident peritoneal dialysis patients (N = 134) were enrolled from 1997 through 2007. We compared CCI scored by the administrative database (A-CCI) with CCI scored by medical records review (R-CCI). These CCI scores and patients' outcomes were analyzed. RESULTS: For all patients, mean A-CCI and R-CCI were 5.3 +/- 2.1 (range 2 - 11) and 5.4 +/- 2.1 (range 2 - 11), respectively. High correlation was found between A-CCI and R-CCI scores (r = 0.88, p < 0.01). The sensitivity of A-CCI was high (0.57 - 1.00) for nine comorbidities, but sensitivities for chronic pulmonary disease and peptic ulcer disease were poor (< 0.50). However, specificity was excellent for most comorbidities. Three comorbidity groups were established by tertile ranking: low comorbidity (score = 2 - 4), moderate comorbidity (score = 5 - 6), and high comorbidity (score = 7-11). The mortality rates were; 7.17, 15.96, and 23.07/100 patient-years by A-CCI, and 6.69, 13.58 and 28.16/100 patient-years by R-CCI, respectively. CONCLUSION: CCI scores from administrative database using ICD-10 were similar to CCI scores by medical records review. This method is simple and valid to predict the outcomes of incipient PD patients.
AIMS: Mortality risks in ESRD (end stage renal disease) patients are related to comorbid diseases. The Charlson Comorbidity Index (CCI) has been reported to be a strong predictor of survival in incipient ESRDpatients. The authors studied the validity of CCI using administrative database according to International Classification of Disease, 10th revision (ICD-10) codes, to devise a more straightforward method of determining CCI than that based on medical records review. SUBJECTS AND METHODS: Incident peritoneal dialysis patients (N = 134) were enrolled from 1997 through 2007. We compared CCI scored by the administrative database (A-CCI) with CCI scored by medical records review (R-CCI). These CCI scores and patients' outcomes were analyzed. RESULTS: For all patients, mean A-CCI and R-CCI were 5.3 +/- 2.1 (range 2 - 11) and 5.4 +/- 2.1 (range 2 - 11), respectively. High correlation was found between A-CCI and R-CCI scores (r = 0.88, p < 0.01). The sensitivity of A-CCI was high (0.57 - 1.00) for nine comorbidities, but sensitivities for chronic pulmonary disease and peptic ulcer disease were poor (< 0.50). However, specificity was excellent for most comorbidities. Three comorbidity groups were established by tertile ranking: low comorbidity (score = 2 - 4), moderate comorbidity (score = 5 - 6), and high comorbidity (score = 7-11). The mortality rates were; 7.17, 15.96, and 23.07/100 patient-years by A-CCI, and 6.69, 13.58 and 28.16/100 patient-years by R-CCI, respectively. CONCLUSION:CCI scores from administrative database using ICD-10 were similar to CCI scores by medical records review. This method is simple and valid to predict the outcomes of incipient PDpatients.
Authors: Terry King-Wing Ma; Kai Ming Chow; Bonnie Ching-Ha Kwan; Jack Kit-Chung Ng; Wing-Fai Pang; Chi Bon Leung; Philip Kam-To Li; Cheuk Chun Szeto Journal: Clin Exp Nephrol Date: 2017-05-29 Impact factor: 2.801