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      Risk adjustment in outcome assessment: the Charlson comorbidity index.

      1 , ,

      Methods of information in medicine

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          Abstract

          To measure the burden of comorbid diseases using the MED-ECHO database (Quebec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in a group of 62,456 patients having one of the following conditions: ischemic heart disease, congestive heart failure, stroke, or bacterial pneumonia. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. When gender, age, comorbidity and the principal diagnoses were taken into account, the area under the receiver-operating curve was 0.83. Therefore, the Charlson Index is a useful approach to risk adjustment in outcomes research from administrative databases.

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          Author and article information

          Journal
          Methods Inf Med
          Methods of information in medicine
          0026-1270
          0026-1270
          Nov 1993
          : 32
          : 5
          Affiliations
          [1 ] Université Catholique de Louvain, Faculté de Médecine, Département des Sciences Hospitalières et Médico-Sociales, Bruxelles, Belgium.
          Article
          93050382
          8295545

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