ADAPTING A CLINICAL COMORBIDITY INDEX FOR USE WITH ICD-9-CM ADMINISTRATIVE DATABASES
ADAPTING A CLINICAL COMORBIDITY INDEX FOR USE WITH ICD-9-CM ADMINISTRATIVE DATABASES
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DOI：
10.1016/0895-4356(92)90133-8
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发表时间：
1992-06-01
影响因子：
7.2
通讯作者：
CIOL, MA
中科院分区：
文献类型：
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作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
行政数据库越来越多地用于研究医疗护理的结果。从这类数据中得出有效的推论需要有考虑疾病严重程度和合并症情况的能力。我们改编了一种临床合并症指数，该指数原是为配合医疗记录使用而设计的，用于依赖国际疾病分类（ICD - 9 - CM）诊断和手术操作编码的研究。然后，我们用1985年接受腰椎手术的医疗保险受益人样本（n = 27111）检验了这种改编后的指数与健康结果和资源使用的关联。该指数与术后并发症、死亡率、输血、转至疗养院、住院时间和住院费用呈预期的相关关系。无论该指数是纳入了一年中多次住院的数据，还是仅来自手术入院时的数据，都观察到了这些关联。在控制患者年龄后，这些关联仍然存在。我们得出结论，改编后的合并症指数将有助于利用行政数据库进行疾病结果和资源使用的研究。
Administrative databases are increasingly used for studying outcomes of medical care. Valid inferences from such data require the ability to account for disease severity and comorbid conditions. We adapted a clinical comorbidity index, designed for use with medical records, for research relying on International Classification of Diseases (ICD-9-CM) diagnosis and procedure codes. The association of this adapted index with health outcomes and resource use was then examined with a sample of Medicare beneficiaries who underwent lumbar spine surgery in 1985 (n = 27,111). The index was associated in the expected direction with postoperative complications, mortality, blood transfusion, discharge to nursing home, length of hospital stay, and hospital charges. These associations were observed whether the index incorporated data from multiple hospitalizations over a year's time, or just from the index surgical admission. They also persisted after controlling for patient age. We conclude that the adapted comorbidity index will be useful in studies of disease outcome and resource use employing administrative databases.