Charlson scores based on ICD-10 administrative data were valid in assessing comorbidity in patients undergoing urological cancer surgery.


Nuttall, M; van der Meulen, J; Emberton, M; (2006) Charlson scores based on ICD-10 administrative data were valid in assessing comorbidity in patients undergoing urological cancer surgery. Journal of clinical epidemiology, 59 (3). pp. 265-73. ISSN 0895-4356 DOI: https://doi.org/10.1016/j.jclinepi.2005.07.015

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Abstract

BACKGROUND AND OBJECTIVES: Adjustment for comorbidity is an essential component of any observational study comparing outcomes. We evaluated the validity of the Charlson comorbidity score based on ICD-10 codes in patients undergoing urological cancer surgery within an English administrative database. STUDY DESIGN AND SETTING: Patients who underwent radical urological cancer surgery between 1998 and 2002 in the English National Health Service were identified from the Hospital Episode Statistics database (N = 20,138). ICD-9-CM codes defining comorbid diseases according to the Deyo and Dartmouth-Manitoba adaptations of the Charlson comorbidity score were translated into ICD-10 codes. RESULTS: Charlson scores derived by the ICD-10 translation of the Deyo and Dartmouth-Manitoba adaptations were identical in 16,623 patients (83%; kappa = .63). For both adaptations, ICD-10 scores increased with age, were higher in patients admitted on an emergency basis, and predicted short-term outcome. Addition of either the ICD-10 Charlson Deyo or Dartmouth-Manitoba score to risk models containing age and sex to predict in-hospital mortality resulted in a better model fit but only in small improvements of the predictive power. CONCLUSION: The ICD-10 translations of the Deyo and Dartmouth-Manitoba adaptations performed similarly in risk models predicting hospital mortality following urological cancer surgery. Adjustment for comorbidity over and above age and sex alone does not seem to provide a large improvement.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 16488357
Web of Science ID: 235824100007
URI: http://researchonline.lshtm.ac.uk/id/eprint/12234

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