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      Development and validation of a structured query language implementation of the Elixhauser comorbidity index

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          Abstract

          Objective: Comorbidity adjustment is often performed during outcomes and health care resource utilization research. Our goal was to develop an efficient algorithm in structured query language (SQL) to determine the Elixhauser comorbidity index.

          Materials and Methods: We wrote an SQL algorithm to calculate the Elixhauser comorbidities from Diagnosis Related Group and International Classification of Diseases (ICD) codes. Validation was by comparison to expected comorbidities from combinations of these codes and to the 2013 Nationwide Readmissions Database (NRD).

          Results: The SQL algorithm matched perfectly with expected comorbidities for all combinations of ICD-9 or ICD-10, and Diagnosis Related Groups. Of 13 585 859 evaluable NRD records, the algorithm matched 100% of the listed comorbidities. Processing time was ∼0.05 ms/record.

          Discussion: The SQL Elixhauser code was efficient and computationally identical to the SAS algorithm used for the NRD.

          Conclusions: This algorithm may be useful where preprocessing of large datasets in a relational database environment and comorbidity determination is desired before statistical analysis. A validated SQL procedure to calculate Elixhauser comorbidities and the van Walraven index from ICD-9 or ICD-10 discharge diagnosis codes has been published.

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          Author and article information

          Journal
          J Am Med Inform Assoc
          J Am Med Inform Assoc
          jamia
          Journal of the American Medical Informatics Association : JAMIA
          Oxford University Press
          1067-5027
          1527-974X
          July 2017
          16 February 2017
          : 24
          : 4
          : 845-850
          Affiliations
          [1 ]Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, FL, USA
          [2 ]Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, IA, USA
          Author notes
          Corresponding Author: Richard H Epstein, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, 1400 NW 12th Ave, Suite 3075, Miami, FL, 33136, USA. E-mail: repstein@ 123456med.miami.edu ; Phone: 305-689-1106; Fax: 305-689-5501.
          Article
          PMC7651966 PMC7651966 7651966 ocw181
          10.1093/jamia/ocw181
          7651966
          28339644
          © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com
          Page count
          Pages: 6
          Categories
          Brief Communications

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