Barbara Toson1, Lara A Harvey2, Jacqueline C T Close3. 1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Barker Street, Randwick, NSW 2031, Australia. Electronic address: b.toson@neura.edu.au. 2. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Barker Street, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, UNSW, Kensington, NSW 2033, Australia. 3. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, UNSW, Randwick, NSW 2052, Australia.
Abstract
OBJECTIVES: To translate, validate, and compare performance of an International Classification of Diseases, 10th revision (ICD-10) version of the Multipurpose Australian Comorbidity Scoring System (MACSS) against commonly used comorbidity measures in the prediction of short- and long-term mortality, 28-day all-cause readmission, and length of stay (LOS). STUDY DESIGN AND SETTING: Hospitalization and death data were linked for 25,374 New South Wales residents aged 65 years and older, admitted with a hip fracture between 2008 and 2012. Comorbidities were identified according to the MACSS, Charlson, and Elixhauser definitions using ICD-10 coding algorithms. Regression models were fitted and area under the curve (AUC) and Akaike Information Criterion assessed. RESULTS: The ICD-10 MACSS had excellent discriminating ability in predicting inhospital mortality (AUC = 0.81) and 30-day mortality (AUC = 0.80), acceptable prediction of 1-year mortality (AUC = 0.76) but poor discrimination for 28-day readmission and LOS. The MACSS algorithm provided better model fit than either Charlson or Elixhauser algorithm for all outcomes. CONCLUSION: This work presents a rigorous translation of the ICD-9 MACSS for use with ICD-10 coded data. The updated ICD-10 MACSS outperformed both Charlson and Elixhauser measures in an older population and is recommended for use with large administrative data sets in predicting mortality outcomes. Copyright Â
OBJECTIVES: To translate, validate, and compare performance of an International Classification of Diseases, 10th revision (ICD-10) version of the Multipurpose Australian Comorbidity Scoring System (MACSS) against commonly used comorbidity measures in the prediction of short- and long-term mortality, 28-day all-cause readmission, and length of stay (LOS). STUDY DESIGN AND SETTING: Hospitalization and death data were linked for 25,374 New South Wales residents aged 65 years and older, admitted with a hip fracture between 2008 and 2012. Comorbidities were identified according to the MACSS, Charlson, and Elixhauser definitions using ICD-10 coding algorithms. Regression models were fitted and area under the curve (AUC) and Akaike Information Criterion assessed. RESULTS: The ICD-10 MACSS had excellent discriminating ability in predicting inhospital mortality (AUC = 0.81) and 30-day mortality (AUC = 0.80), acceptable prediction of 1-year mortality (AUC = 0.76) but poor discrimination for 28-day readmission and LOS. The MACSS algorithm provided better model fit than either Charlson or Elixhauser algorithm for all outcomes. CONCLUSION: This work presents a rigorous translation of the ICD-9 MACSS for use with ICD-10 coded data. The updated ICD-10 MACSS outperformed both Charlson and Elixhauser measures in an older population and is recommended for use with large administrative data sets in predicting mortality outcomes. Copyright Â
Authors: Viviane Cristina Uliana Peterle; Maria Rita Carvalho Garbi Novaes; Paulo Emiliano Bezerra Junior; João Carlos Geber Júnior; Rodrigo Tinôco Magalhães Cavalcante; Jurandi Barrozo da Silva Junior; Ray Costa Portela; Ana Patricia de Paula Journal: PLoS One Date: 2022-08-12 Impact factor: 3.752