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Utilizing national patient-register data to control for comorbidity in prognostic studies.

Nilssen Y, Strand TE, Wiik R, Bakken IJ, Yu XQ, O'Connell DL, Møller B - Clin Epidemiol (2014)

Bottom Line: When the PRI was added to the model including age and sex, the age effects were reduced by up to 38% for patients older than 50 years.All measures of model fit improved for the PRI model.Adjustment for comorbidity is especially important for patients 50 years of age or older, and its effect on 1-year mortality is almost comparable to the age effect.

View Article: PubMed Central - PubMed

Affiliation: Department of Registration, Cancer Registry of Norway, Oslo, Norway.

ABSTRACT

Objective: To construct an updated comorbidity index (Patient Register Index [PRI]) using national data collections from Norway and compare its predictive ability of 1-year mortality with the Charlson Comorbidity Index (CCI).

Materials and methods: Data regarding over 1.11 million patients registered in the Norwegian Patient Register in 2010 and 2011 were used to construct the PRI. The PRI was evaluated by comparing its model fit and discrimination with the CCI.

Results: Compared with the CCI, the PRI weights decreased for six, increased for four, and were unchanged for seven diseases. When the PRI was added to the model including age and sex, the age effects were reduced by up to 38% for patients older than 50 years. All measures of model fit improved for the PRI model.

Conclusion: Adjustment for comorbidity is especially important for patients 50 years of age or older, and its effect on 1-year mortality is almost comparable to the age effect. The PRI is based on more recent data than the CCI, and is more representative of the general population due to its construction.

No MeSH data available.


Related in: MedlinePlus

Total proportion of the Norwegian population admitted to hospitals in 2010–2011 in Norway or with a condition included in the Charlson Comorbidity Index (CCI) present within the previous year, by sex and age-group.Notes: Data shown are for (A) women and (B) men.
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f2-clep-6-395: Total proportion of the Norwegian population admitted to hospitals in 2010–2011 in Norway or with a condition included in the Charlson Comorbidity Index (CCI) present within the previous year, by sex and age-group.Notes: Data shown are for (A) women and (B) men.

Mentions: The majority of the 1,113,341 patients in the study were women (57.0%). For 68.1% of the patients, the index visit was a hospitalization. Figure 2 presents the proportion of the Norwegian population with one or more of the CCI diseases in 2010–2011 and the total proportion admitted to Norwegian hospitals in that same period. Twenty-two percent of the patients were registered with at least one CCI disease, but among men and women below 50 years of age, the proportion was less than 3%. For patients 50 years of age or older, the proportion with CCI diseases increased with age, and the increase was more prominent among men. For both sexes, there was a strikingly high proportion of hospital admission in the youngest age-group (0–4 years). This was mostly due to diseases of the respiratory system (data not shown). For women, there was a peak around 30–34 years (Figure 2) as a result of birth-related admissions (data not shown). There was a small peak for men aged 20–24 years as well, which was mostly attributed to ICD-10 codes within S00-T98 (“Injury, poisoning, and certain other consequences of external causes”, data not shown).


Utilizing national patient-register data to control for comorbidity in prognostic studies.

Nilssen Y, Strand TE, Wiik R, Bakken IJ, Yu XQ, O'Connell DL, Møller B - Clin Epidemiol (2014)

Total proportion of the Norwegian population admitted to hospitals in 2010–2011 in Norway or with a condition included in the Charlson Comorbidity Index (CCI) present within the previous year, by sex and age-group.Notes: Data shown are for (A) women and (B) men.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4216019&req=5

f2-clep-6-395: Total proportion of the Norwegian population admitted to hospitals in 2010–2011 in Norway or with a condition included in the Charlson Comorbidity Index (CCI) present within the previous year, by sex and age-group.Notes: Data shown are for (A) women and (B) men.
Mentions: The majority of the 1,113,341 patients in the study were women (57.0%). For 68.1% of the patients, the index visit was a hospitalization. Figure 2 presents the proportion of the Norwegian population with one or more of the CCI diseases in 2010–2011 and the total proportion admitted to Norwegian hospitals in that same period. Twenty-two percent of the patients were registered with at least one CCI disease, but among men and women below 50 years of age, the proportion was less than 3%. For patients 50 years of age or older, the proportion with CCI diseases increased with age, and the increase was more prominent among men. For both sexes, there was a strikingly high proportion of hospital admission in the youngest age-group (0–4 years). This was mostly due to diseases of the respiratory system (data not shown). For women, there was a peak around 30–34 years (Figure 2) as a result of birth-related admissions (data not shown). There was a small peak for men aged 20–24 years as well, which was mostly attributed to ICD-10 codes within S00-T98 (“Injury, poisoning, and certain other consequences of external causes”, data not shown).

Bottom Line: When the PRI was added to the model including age and sex, the age effects were reduced by up to 38% for patients older than 50 years.All measures of model fit improved for the PRI model.Adjustment for comorbidity is especially important for patients 50 years of age or older, and its effect on 1-year mortality is almost comparable to the age effect.

View Article: PubMed Central - PubMed

Affiliation: Department of Registration, Cancer Registry of Norway, Oslo, Norway.

ABSTRACT

Objective: To construct an updated comorbidity index (Patient Register Index [PRI]) using national data collections from Norway and compare its predictive ability of 1-year mortality with the Charlson Comorbidity Index (CCI).

Materials and methods: Data regarding over 1.11 million patients registered in the Norwegian Patient Register in 2010 and 2011 were used to construct the PRI. The PRI was evaluated by comparing its model fit and discrimination with the CCI.

Results: Compared with the CCI, the PRI weights decreased for six, increased for four, and were unchanged for seven diseases. When the PRI was added to the model including age and sex, the age effects were reduced by up to 38% for patients older than 50 years. All measures of model fit improved for the PRI model.

Conclusion: Adjustment for comorbidity is especially important for patients 50 years of age or older, and its effect on 1-year mortality is almost comparable to the age effect. The PRI is based on more recent data than the CCI, and is more representative of the general population due to its construction.

No MeSH data available.


Related in: MedlinePlus