Deyo R A, Cherkin D C, Ciol M A
Department of Medicine, University of Washington, Seattle 98195.
J Clin Epidemiol. 1992 Jun;45(6):613-9. doi: 10.1016/0895-4356(92)90133-8.
Administrative databases are increasingly used for studying outcomes of medical care. Valid inferences from such data require the ability to account for disease severity and comorbid conditions. We adapted a clinical comorbidity index, designed for use with medical records, for research relying on International Classification of Diseases (ICD-9-CM) diagnosis and procedure codes. The association of this adapted index with health outcomes and resource use was then examined with a sample of Medicare beneficiaries who underwent lumbar spine surgery in 1985 (n = 27,111). The index was associated in the expected direction with postoperative complications, mortality, blood transfusion, discharge to nursing home, length of hospital stay, and hospital charges. These associations were observed whether the index incorporated data from multiple hospitalizations over a year's time, or just from the index surgical admission. They also persisted after controlling for patient age. We conclude that the adapted comorbidity index will be useful in studies of disease outcome and resource use employing administrative databases.
行政数据库越来越多地用于研究医疗保健结果。从这些数据中得出有效的推论需要考虑疾病严重程度和共病情况的能力。我们改编了一个专为医疗记录设计的临床共病指数，用于依赖国际疾病分类（ICD - 9 - CM）诊断和程序代码的研究。然后，我们对1985年接受腰椎手术的医疗保险受益人的样本（n = 27,111）进行了研究，以检验这个改编指数与健康结果和资源使用之间的关联。该指数与术后并发症、死亡率、输血、转至疗养院、住院时间和住院费用呈预期方向的关联。无论该指数纳入的是一年时间内多次住院的数据，还是仅来自手术入院的数据，这些关联都能观察到。在控制了患者年龄后，这些关联依然存在。我们得出结论，改编后的共病指数将有助于使用行政数据库进行疾病结果和资源使用的研究。
