Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea

Lee, Sang‐Hee; Chang, Yoon Jung; Cho, Hyunsoon

doi:10.1186/s12874-021-01257-2

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…Since all patients in this cohort study had RA, and we were interested in how comorbidities, not RA, affected outcomes. We used an adjusted score that removed the rheumatic components of the CCI (a maximum of 1 point was deducted from the score) [ 18 – 20 ]. Using this data, we estimated survival to mortality (from first RA record) and rates of, and time to adverse outcome of revision, peri-prosthetic fracture, infection, VTE, and mechanical loosening using further ICD codes (Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

Total Hip Replacement in Patients with Rheumatoid Arthritis: Trends in Incidence and Complication Rates Over 35 Years

et al. 2022

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Introduction: Advances in rheumatoid arthritis (RA) management have made disease remission achievable. We evaluated trends in total hip replacement (THR) and postoperative outcomes in patients with RA in Western Australia (WA) over more than three decades. Methods: This was a retrospective analysis of routinely collected prospective data from a state-wide registry containing longitudinally linked administrative health data based on International Classification of Diseases (ICD) diagnostic and procedural codes. We included patients with two or more diagnostic codes for RA (between 1980 and 2015) and studied THR incidence rates (THR IR) and complication rates (revision, peri-prosthetic fracture, infection, venous thrombosis, and mechanical loosening). Survival rates were estimated by Kaplan-Meier method and predictors analyzed by Cox regression. Results: We followed 9201 RA patients over 111,625 person-years, during which 1560 patients (16.9%) underwent THR. From 1985 to 2015, THR IR (per 1000 RA patient-years) decreased from 20.8 (95% CI 20.1-21.5) to 7.3 (95% CI 7.2-7.5), and 5-year THR-free survival increased from 84.3 to 95.3% . Tenyear prosthetic survival was 91.2%. Complication rates in the first 5 years post-THR decreased significantly from 13.1 to 3.7% (p \ 0.001). Mechanical complications such as loosening and periprosthetic fracture rates decreased significantly ([ 35%, P \ 0.05), while infection and revision did not change over the observation period (p [ 0.05). Conclusions: Over the last 30 years in RA patients, THR IR and mechanical complication rates decreased significantly, but the medical complication of infection has not changed significantly.

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Section: Methodsmentioning

confidence: 99%

Total Hip Replacement in Patients with Rheumatoid Arthritis: Trends in Incidence and Complication Rates Over 35 Years

et al. 2022

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Predictive accuracy of comorbidity index models in assessing mortality risk among hemodialysis patients: A comprehensive single‐center observational cohort study

Yu,

Li,

Wang

et al. 2024

Aging Medicine

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ObjectivesComorbidity prediction models have been demonstrated to offer more comprehensive and accurate predictions of death risk compared to single indices. However, their application in China has been limited, particularly among maintenance hemodialysis (MHD) patients. Therefore, the objective of this study was to evaluate the utility of comorbidity index models in predicting mortality risk among Chinese MHD patients.MethodologyThe MHD patients in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were taken as the subjects. Claims‐based disease‐specific refinements matching translation to ICD‐10 and flexibility (CDMF‐CCI) model and Liu model were selected as the candidate models for this verification research. Univariate and multivariate Cox regression calculations were used to analyze the independent predictive effect of the models on survival rate.ResultsAnnually, nearly 500 patients undergo hemodialysis treatment. From January 2019 to June 2022, a total of 199 patients succumbed, with a mean age of 65.2 years. During these 4 years, the mortality rates were 13.04%, 9.68%, 11.69%, and 6.39%, respectively. The leading causes of death were sudden demise (82 patients, 41.2%), cardiovascular disease (48 patients, 24.1%), pulmonary infection (33 patients, 16.5%), and stroke (19 patients, 9.5%). When compared to individual indices, the CDMF‐CCI model displayed more accurate and predictive results, with an HR of 1.190 (P = 0.037). Conversely, the Liu model failed to identify high‐risk individuals.ConclusionThe MHD patients face a significant risk of mortality. When compared to univariate parameters and the Liu model, the CDMF‐CCI model exhibits superior predictive accuracy for mortality in MHD patients.

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Long-term exposure to PM2.5 and mortality: a national health insurance cohort study

Moon,

Kim,

Jang

et al. 2024

International Journal of Epidemiology

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Background Previous studies with large data have been widely reported that exposure to fine particulate matter (PM2.5) is associated with all-cause mortality; however, most of these studies adopted ecological time-series designs or have included limited study areas or individuals residing in well-monitored urban areas. However, nationwide cohort studies including cause-specific mortalities with different age groups were sparse. Therefore, this study examined the association between PM2.5 and cause-specific mortality in South Korea using the nationwide cohort. Methods A longitudinal cohort with 187 917 National Health Insurance Service-National Sample Cohort participants aged 50–79 years in enrolment between 2002 and 2019 was used. Annual average PM2.5 was collected from a machine learning-based ensemble model (a test R2 = 0.87) as an exposure. We performed a time-varying Cox regression model to examine the association between long-term PM2.5 exposure and mortality. To reduce the potential estimation bias, we adopted generalized propensity score weighting method. Results The association with long-term PM2.5 (2-year moving average) was prominent in mortalities related to diabetes mellitus [hazard ratio (HR): 1.03 (95% CI: 1.01, 1.06)], circulatory diseases [HR: 1.02 (95% CI: 1.00, 1.03)] and cancer [HR: 1.01 (95% CI: 1.00, 1.02)]. Meanwhile, circulatory-related mortalities were associated with a longer PM2.5 exposure period (1 or 2-year lags), whereas respiratory-related mortalities were associated with current-year PM2.5 exposure. In addition, the association with PM2.5 was more evident in people aged 50–64 years than in people aged 65–79 years, especially in heart failure-related deaths. Conclusions This study identified the hypothesis that long-term exposure to PM2.5 is associated with mortality, and the association might be different by causes of death. Our result highlights a novel vulnerable population: the middle-aged population with risk factors related to heart failure.

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Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea

Cited by 4 publications

References 33 publications

Total Hip Replacement in Patients with Rheumatoid Arthritis: Trends in Incidence and Complication Rates Over 35 Years

Total Hip Replacement in Patients with Rheumatoid Arthritis: Trends in Incidence and Complication Rates Over 35 Years

Predictive accuracy of comorbidity index models in assessing mortality risk among hemodialysis patients: A comprehensive single‐center observational cohort study

Long-term exposure to PM2.5 and mortality: a national health insurance cohort study

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