Department of Traumatology and Orthopaedics, University of Tartu, L. Puusepa 8, 50406, Tartu, Estonia.
Traumatology and Orthopaedics Clinic, Tartu University Hospital, L. Puusepa 8, 50406, Tartu, Estonia.
BMC Med Res Methodol. 2022 Jan 7;22(1):4. doi: 10.1186/s12874-021-01492-7.
The Charlson and Elixhauser Comorbidity Indices are the most widely used comorbidity assessment methods in medical research. Both methods are adapted for use with the International Classification of Diseases, which 10th revision (ICD-10) is used by over a hundred countries in the world. Available Charlson and Elixhauser Comorbidity Index calculating methods are limited to a few applications with command-line user interfaces, all requiring specific programming language skills. This study aims to use Microsoft Excel to develop a non-programming and ICD-10 based dataset calculator for Charlson and Elixhauser Comorbidity Index and to validate its results with R- and SAS-based methods.
The Excel-based dataset calculator was developed using the program's formulae, ICD-10 coding algorithms, and different weights of the Charlson and Elixhauser Comorbidity Index. Real, population-wide, nine-year spanning, index hip fracture data from the Estonian Health Insurance Fund was used for validating the calculator. The Excel-based calculator's output values and processing speed were compared to R- and SAS-based methods.
A total of 11,491 hip fracture patients' comorbidities were used for validating the Excel-based calculator. The Excel-based calculator's results were consistent, revealing no discrepancies, with R- and SAS-based methods while comparing 192,690 and 353,265 output values of Charlson and Elixhauser Comorbidity Index, respectively. The Excel-based calculator's processing speed was slower but differing only from a few seconds up to four minutes with datasets including 6250-200,000 patients.
This study proposes a novel, validated, and non-programming-based method for calculating Charlson and Elixhauser Comorbidity Index scores. As the comorbidity calculations can be conducted in Microsoft Excel's simple graphical point-and-click interface, the new method lowers the threshold for calculating these two widely used indices.
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Charlson 和 Elixhauser 合并症指数是医学研究中使用最广泛的合并症评估方法。这两种方法都适用于国际疾病分类，世界上有 100 多个国家使用第 10 次修订版（ICD-10）。现有的 Charlson 和 Elixhauser 合并症指数计算方法仅限于少数具有命令行用户界面的应用程序，所有这些都需要特定的编程语言技能。本研究旨在使用 Microsoft Excel 开发一种非编程和基于 ICD-10 的数据集计算器，用于计算 Charlson 和 Elixhauser 合并症指数，并使用基于 R 和 SAS 的方法验证其结果。
使用该程序的公式、ICD-10 编码算法和 Charlson 和 Elixhauser 合并症指数的不同权重，开发了基于 Excel 的数据集计算器。使用来自爱沙尼亚健康保险基金的为期 9 年、跨越整个人群的真实索引髋部骨折数据对计算器进行验证。比较了基于 Excel 的计算器的输出值和处理速度与基于 R 和 SAS 的方法。
共有 11491 例髋部骨折患者的合并症用于验证基于 Excel 的计算器。在比较 Charlson 和 Elixhauser 合并症指数的 192690 和 353265 个输出值时，基于 Excel 的计算器的结果与基于 R 和 SAS 的方法一致，没有差异。基于 Excel 的计算器的处理速度较慢，但仅相差几秒钟至四分钟，数据集中包括 6250-200000 名患者。
本研究提出了一种新颖的、经过验证的、非编程的计算 Charlson 和 Elixhauser 合并症指数评分的方法。由于合并症计算可以在 Microsoft Excel 的简单图形点击界面中进行，因此新方法降低了计算这两个广泛使用的指数的门槛。
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