The development of a comorbidity index with physical function as the outcome
The development of a comorbidity index with physical function as the outcome
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DOI：
10.1016/j.jclinepi.2004.10.018
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发表时间：
2005-06-01
影响因子：
7.2
通讯作者：
Wright, JG
中科院分区：
文献类型：
--
作者：
Groll, DL;To, T;Wright, JG
背景和目标：身体功能是许多医疗和外科手术成功与否的重要衡量标准。调整共病的能力对于卫生服务研究和流行病学研究至关重要。目前的指标主要以死亡率为结果，对于身体机能结果不够敏感。本研究的目的是制定一个以身体功能为结果的自我管理功能合并症指数。方法：该指数是使用两个数据库开发的：9,423 名加拿大成年人的横断面简单随机样本和 28,349 名寻求脊柱疾病治疗的美国成年人的样本。主要结果指标是 SF-36 身体机能 (PF) 子量表。 结果：与 Charlson（模型 R-2 = 0.18）和 Kaplan-Feinstein（模型 R-2 = 0.07）指数相比，功能性合并症指数（18 项诊断列表）与身体机能（模型 R-2 = 0.29）有更强的相关性。功能共病指数在 77% 的病例中正确地将患者分为高功能和低功能。结论：这个新指数包含用于预测死亡率的指数中未发现的关节炎等诊断，并且与旨在预测死亡率的指数相比，FCI 解释了 PF 评分的更多差异。 (c) 2005 Elsevier Inc. 保留所有权利。
Background and Objectives: Physical function is an important measure of success of many medical and surgical interventions. Ability to adjust for comorbid disease is essential in health services research and epidemiologic studies. Current indices have primarily been developed with mortality as the outcome, and are not sensitive enough when the outcome is physical function. The objective of this study was to develop a self-administered Functional Comorbidity Index with physical function as the outcome.Methods: The index was developed using two databases: a cross-sectional, simple random sample of 9,423 Canadian adults and a sample of 28,349 US adults seeking treatment for spine ailments. The primary outcome measure was the SF-36 physical function (PF) subscale.Results: The Functional Comorbidity Index, an 18-item list of diagnoses, showed stronger association with physical function (model R-2 = 0.29) compared with the Charlson (model R-2 = 0.18), and Kaplan-Feinstein (model R-2 = 0.07) indices. The Functional Comorbidity Index correctly classified patients into high and low function, in 77% of cases.Conclusion: This new index contains diagnoses such as arthritis not found on indices used to predict mortality, and the FCI explained more variance in PF scores compared to indices designed to predict mortality. (c) 2005 Elsevier Inc. All rights reserved.