Kim Chul-Gyu, Bae Kyun-Seop
Department of Nursing, Chungbuk National University, Cheongju 28644, Republic of Korea.
Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Healthcare (Basel). 2023 Jun 22;11(13):1830. doi: 10.3390/healthcare11131830.
Comorbidity indices such as Charlson's (CCI) and Elixhauser's (ECI) are used to adjust the patient's care, depending on the severity of their condition. However, no study has compared these indices' ability to predict nursing-sensitive outcomes (NSOs). We compared the performance of CCI and ECI in predicting NSOs in gastric cancer patients' gastrectomy. Gastric cancer patients with gastrectomy, aged 19 years or older and admitted between 2015 and 2016, were selected from the Korea Insurance Review and Assessment Service database. We examined the relationships between NSOs and CCI or ECI while adjusting patient and hospital characteristics with logistic regression. The ECI item model was the best in view of the C-statistic and Akaike Information Criterion for total NSO, physiologic/metabolic derangement, and deep vein thrombosis, while the Charlson item model was the best for upper gastrointestinal tract bleeding. For the C-statistic, the ECI item model was the best for in-hospital mortality, CNS complications, shock/cardiac arrest, urinary tract infection, pulmonary failure, and wound infection, while the CCI item model was the best for hospital-acquired pneumonia and pressure ulcers. In predicting 8 of 11 NSOs, the ECI item model outperformed the others. For other NSOs, the best model varies between the ECI item and CCI item model.
诸如查尔森合并症指数（CCI）和埃利克斯豪泽合并症指数（ECI）等合并症指数，用于根据患者病情的严重程度来调整其护理。然而，尚无研究比较过这些指数预测护理敏感结局（NSO）的能力。我们比较了CCI和ECI在预测胃癌患者胃切除术后NSO方面的表现。从韩国保险审查与评估服务数据库中选取了2015年至2016年间收治的年龄在19岁及以上且接受了胃切除术的胃癌患者。我们通过逻辑回归在调整患者和医院特征的同时，研究了NSO与CCI或ECI之间的关系。就总NSO、生理/代谢紊乱和深静脉血栓形成的C统计量和赤池信息准则而言，ECI分项模型最佳，而查尔森分项模型在上消化道出血方面表现最佳。对于C统计量，ECI分项模型在院内死亡率、中枢神经系统并发症、休克/心脏骤停、尿路感染、肺衰竭和伤口感染方面表现最佳，而CCI分项模型在医院获得性肺炎和压疮方面表现最佳。在预测11项NSO中的8项时，ECI分项模型的表现优于其他模型。对于其他NSO，最佳模型在ECI分项模型和CCI分项模型之间有所不同。
