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Comorbidity information in older patients at an emergency visit: self-report vs. administrative data had poor

Stephanie R Susser1, Jane McCusker, Eric Belzile

  • 1Faculty of Medicine, McGill University, Canada.

Journal of Clinical Epidemiology
|April 9, 2008
PubMed

Insights

Self-reported Charlson Comorbidity Index (CCI) and administrative CCI show poor to fair agreement in older emergency department patients. However, both methods demonstrate similar predictive validity for health outcomes.

Area of Science:

  • Geriatric Medicine
  • Health Services Research
  • Epidemiology

Background:

  • Accurate comorbidity assessment is crucial for predicting patient outcomes.
  • The Charlson Comorbidity Index (CCI) is widely used but its data sources can vary.
  • Self-report and administrative data are common sources for CCI calculation.

Purpose of the Study:

  • To evaluate agreement between self-reported and administrative Charlson Comorbidity Index (CCI) in older emergency department (ED) patients.
  • To identify factors influencing agreement between the two CCI data sources.
  • To compare the predictive validity of self-reported vs. administrative CCI for health services utilization and functional decline.

Main Methods:

  • Secondary analysis of data from a randomized controlled trial involving 520 older ED patients.
  • Comparison of self-report and administrative CCI using intraclass correlation coefficient (ICC).
  • Analysis of subsequent health services utilization and functional decline to assess predictive validity.

Main Results:

  • Agreement between self-report and administrative CCI was poor to fair (overall weighted ICC = 0.43).
  • Factors like health service utilization, age, and sex did not significantly alter agreement.
  • Predictive validity was comparable between the two CCI indices (AUC 0.51-0.66).

Conclusions:

  • Self-reported comorbidity data shows limited agreement with administrative records for CCI calculation.
  • Despite poor agreement, both self-reported and administrative CCI possess similar predictive capabilities for health outcomes in older ED patients.
Abstract

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