The Australian Injury Comorbidity Indices (AICIs) to predict in-hospital complications: A population-based data linkage study

Abstract

Background Hospital-admitted patients are at risk of experiencing certain adverse outcomes during their hospital-stay. Patients may need to be admitted to the intensive care unit or be placed on the ventilator while there is also a possibility for complications to develop. Pre-existing comorbidity could increase the risk of these outcomes. The Charlson Comorbidity Index (CCI) and the Elixhauser Comorbidity Measure (ECM), originally derived for mortality outcomes among general medical populations, are widely used for assessing these in-hospital complications even among specific injury populations. This study derived indices to specifically capture the effect of comorbidity on intensive care unit and ventilator use as well as hospital-acquired complications for injury patients. Methods Retrospective data on injury hospital-admissions from July 2012 to June 2014 (161,334 patients) for the state of Victoria, Australia was analysed. Results from multivariable regression analysis were used to derive the Australian Injury Comorbidity Indices (AICIs) for intensive care unit and ventilator hours and hospital-acquired complications. The AICIs, CCI and ECM were validated on data from Victoria and two other Australian states. Results Five comorbidities were significantly associated with intensive care unit hours, two with ventilator hours and fifteen with hospital-acquired complications for hospitalised injury patients. Not all diseases listed in the CCI or ECM were found to be associated with these outcomes. The AICIs performed equally well in terms of predictive ability to the long-listed ECM and in most instances outperformed the CCI.

Risk Factors for Unplanned ICU Readmission Among Trauma Patients: Age Matters

“…The optimal metric to quantify the burden of preexisting medical conditions among trauma patients is a topic of ongoing research and debate, and the limitations of CCI in trauma patients are well described (34)(35)(36). analysis demonstrated that several preexisting medical conditions included in CCI were not associated with risk of UIR in either the adult or elderly patient cohorts.…”

Risk of early mortality and cardiovascular disease according to the presence of recently diagnosed diabetes and requirement for insulin treatment: A nationwide study

“…Presence of hypertension 15 , dyslipidemia 15 , atrial fibrillation (AF) 4 , 19 , 20 , hospitalization for heart failure (hHF) 4 , 21 , 22 , dementia 23 , 24 , and end‐stage renal disease (ESRD) 14 were defined according to previous studies. Charlson Comorbidity Index (CCI) was calculated according to the established method 25 , 26 based on the diagnostic codes provided in previous reports 27 , 28 . Low‐income level was assigned to the lowest 20% of the entire population based on monthly household income.…”