Prediction of mortality in patients undergoing maintenance hemodialysis by Charlson Comorbidity Index using ICD-10...

Area of Science:

• Nephrology
• Clinical Epidemiology
• Health Outcomes Research

Background:

• End-stage renal disease (ESRD) patients often have comorbidities impacting outcomes.
• The Charlson Comorbidity Index (CCI) is a validated tool for predicting mortality in ESRD.
• Accurate comorbidity assessment is crucial for managing ESRD patients on hemodialysis (HD).

Purpose of the Study:

• To evaluate the Charlson Comorbidity Index (CCI) as a predictor of mortality in incident maintenance hemodialysis (HD) patients.
• To analyze mortality rates based on CCI scores derived from International Classification of Disease, 10th revision (ICD-10) codes.
• To determine the association between comorbidity burden and patient survival in ESRD.

Main Methods:

• Retrospective analysis of 456 incident maintenance HD patients.
• Calculation of CCI scores using International Classification of Disease, 10th revision (ICD-10) codes from hospital discharge data.
• Stratification of patients into four CCI-based comorbidity groups (low, moderate, high, very high) for mortality analysis.

Main Results:

• Diabetes with end-organ damage was the most prevalent comorbidity (51.1%).
• Mean CCI score was 5.09 ± 2.01.
• Mortality rates significantly increased across CCI quartiles: 0.83 (low), 7.70 (moderate), 14.09 (high), and 18.69 deaths/100 patient-years (very high) (p = 0.001).
• Hazard ratios for mortality increased substantially with higher CCI groups compared to the low comorbidity group.

Conclusions:

• CCI scores derived from ICD-10 data are significant predictors of mortality in incident maintenance HD patients.
• The CCI provides valuable prognostic information for ESRD patients undergoing hemodialysis.
• Comorbidity assessment using CCI aids in risk stratification and clinical decision-making for ESRD management.