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Charlson comorbidity index using administrative database in incident PD patients

S-H Jang1, J-W Chea, K-B Lee

  • 1Division of Nephrology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Clinical Nephrology
|February 25, 2010
PubMed

Insights

The Charlson Comorbidity Index (CCI) calculated from administrative data accurately predicts outcomes in end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD). This administrative method (A-CCI) offers a simpler, valid alternative to manual record review (R-CCI) for assessing patient survival risk.

Area of Science:

  • Nephrology
  • Epidemiology
  • Health Informatics

Background:

  • Mortality in end-stage renal disease (ESRD) patients is significantly influenced by comorbid conditions.
  • The Charlson Comorbidity Index (CCI) is a recognized predictor of survival in ESRD patients.
  • Current CCI assessment often relies on time-consuming medical record reviews.

Purpose of the Study:

  • To evaluate the validity of using administrative database International Classification of Disease, 10th revision (ICD-10) codes for calculating CCI.
  • To establish a more straightforward method for determining CCI compared to manual review.
  • To assess the utility of administrative CCI (A-CCI) in predicting outcomes for peritoneal dialysis (PD) patients.

Main Methods:

  • Incident PD patients (N=134) from 1997-2007 were analyzed.
  • CCI scores derived from administrative data (A-CCI) were compared with those from medical records review (R-CCI).
  • Correlation, sensitivity, and specificity of A-CCI were assessed against R-CCI and patient outcomes.

Main Results:

  • A-CCI and R-CCI demonstrated high correlation (r=0.88, p<0.01), with similar mean scores (5.3 vs 5.4).
  • A-CCI showed high sensitivity for most comorbidities, though lower for chronic pulmonary and peptic ulcer disease.
  • Mortality rates across low, moderate, and high comorbidity groups showed consistent trends between A-CCI and R-CCI, indicating predictive validity.

Conclusions:

  • CCI scores derived from administrative ICD-10 data closely mirror those from medical record reviews.
  • This administrative approach provides a simple and valid method for predicting outcomes in incident PD patients.
  • The A-CCI method offers a practical alternative for risk stratification in ESRD populations.
Abstract

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