A combined comorbidity score predicted mortality in elderly patients better than existing scores

Abstract

OBJECTIVE-To develop and validate a single numeric comorbidity score for predicting shortand long-term mortality, by combining conditions in the Charlson and Elixhauser measures.STUDY DESIGN AND SETTING-In a cohort of 120,679 Pennsylvania Medicare enrollees with drug coverage through a pharmacy assistance program, we developed a single numeric comorbidity score for predicting 1-year mortality, by combining the conditions in the Charlson and Elixhauser measures. We externally validated the combined score in a cohort of New Jersey Medicare enrollees, by comparing its performance to that of both component scores in predicting 1-year mortality, as well as 180-, 90-, and 30-day mortality. CONCLUSION-In similar populations and data settings, the combined score may offer improvements in comorbidity summarization over existing scores. RESULTS-C-statistics

Safety and Efficacy of Novel Oral Anticoagulants Versus Warfarin in Medicare Beneficiaries With Atrial Fibrillation and Valvular Heart Disease

“…A modified hypertension, abnormal renal and liver functions, stroke, bleeding, labile international normalized ratio, elderly, drugs, or alcohol score was used to represent bleeding risk15 (international normalized ratio history was not reflected in our score because laboratory values were not available). We applied a previously validated comorbidity score, as defined by Gagne and colleagues, to quantify comorbidity burden 16. Furthermore, we extracted data pertaining to health care use (number of inpatient hospital days, skilled nursing facility stay, and extended care stay) and medication use (insulin, statins, β blockers, calcium channel blockers, aspirin, clopidogrel, proton pump inhibitors, and nonsteroidal anti‐inflammatory drug use).…”

Outcomes of Patients with Healthcare-Associated Pneumonia: Worse Disease or Sicker Patients?

“…3.1), we recorded the presence of comorbid conditions. 8 We also created a numerical comorbidity summary score based on the work of Gagne et al 9 …”

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries

“…However, all available mortality prediction models have been developed using data from a single study, but all from the United States and Western Europe (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), which greatly limits their validity for use even in other high-income countries, let alone in the developing countries. For instance, a model developed using data from the Health and Retirement Study (HRS) in the United States showed poor performance when it was applied to older adults in England (18).…”