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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

Age-standardized proportion (%) of the Norwegian population admitted to hospitals in 2010–2011 in Norway with any of the 17 conditions in the Charlson Comorbidity Index present within the last year, by sex.Abbreviations: dis, disease; chr, chronic; compl, complications; mod, moderate; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.
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f3-clep-6-395: Age-standardized proportion (%) of the Norwegian population admitted to hospitals in 2010–2011 in Norway with any of the 17 conditions in the Charlson Comorbidity Index present within the last year, by sex.Abbreviations: dis, disease; chr, chronic; compl, complications; mod, moderate; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.

Mentions: The age-standardized proportions of the Norwegian population with each of the CCI diseases are shown in Figure 3. The five most common CCI diseases for men and women were myocardial infarction, cerebrovascular disease, chronic pulmonary disease, diabetes without chronic complications, and malignancies, but the order of importance differed.


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)

Age-standardized proportion (%) of the Norwegian population admitted to hospitals in 2010–2011 in Norway with any of the 17 conditions in the Charlson Comorbidity Index present within the last year, by sex.Abbreviations: dis, disease; chr, chronic; compl, complications; mod, moderate; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.
© Copyright Policy
Related In: Results  -  Collection

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

f3-clep-6-395: Age-standardized proportion (%) of the Norwegian population admitted to hospitals in 2010–2011 in Norway with any of the 17 conditions in the Charlson Comorbidity Index present within the last year, by sex.Abbreviations: dis, disease; chr, chronic; compl, complications; mod, moderate; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.
Mentions: The age-standardized proportions of the Norwegian population with each of the CCI diseases are shown in Figure 3. The five most common CCI diseases for men and women were myocardial infarction, cerebrovascular disease, chronic pulmonary disease, diabetes without chronic complications, and malignancies, but the order of importance differed.

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