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Charlson index scores from administrative data and case-note review compared favourably in a renal disease cohort

Marjorie C Johnston1, Angharad Marks2, Michael A Crilly3

  • 11 Chronic Disease Research Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK 2 NHS Grampian, Summerfield House, Aberdeen, AB15 6RE, UK marjorie.johnston@abdn.ac.uk.

European Journal of Public Health
|January 14, 2015
PubMed

Insights

Administrative data Charlson index scores effectively predict mortality in chronic kidney disease patients, comparing favorably to case-note review. Neither method predicted renal replacement therapy initiation.

Area of Science:

  • Nephrology
  • Epidemiology
  • Health Services Research

Background:

  • The Charlson index is a standard comorbidity measure.
  • Comparing administrative data to case-note review (CNR) for Charlson index calculation is crucial for chronic kidney disease (CKD) cohorts.
  • The Grampian Laboratory Outcomes Mortality and Morbidity Study (GLOMMS-1) cohort provides a valuable dataset for this comparison.

Purpose of the Study:

  • To compare Charlson index scores derived from administrative data versus CNR.
  • To evaluate the association of these scores with all-cause mortality and renal replacement therapy (RRT) initiation in CKD patients.

Main Methods:

  • Modified Charlson index scores were calculated using both administrative data and CNR within the GLOMMS-1 cohort.
  • Agreement between the two scoring methods was assessed using weighted Kappa.
  • Association with outcomes (mortality, RRT initiation) was analyzed using Poisson regression and net reclassification improvement.

Main Results:

  • Moderate agreement (weighted kappa 0.41) was observed between administrative data and CNR-derived Charlson scores.
  • Both scoring methods were associated with all-cause mortality, independent of confounders.
  • Administrative data Charlson scores showed a stronger association with mortality than CNR scores, as indicated by net reclassification improvement.
  • Neither Charlson index score was significantly associated with commencing RRT.

Conclusions:

  • Modified Charlson index scores from both administrative data and CNR are associated with mortality in CKD patients.
  • Administrative data may be a superior source for the Charlson index in predicting mortality compared to CNR.
  • Neither method demonstrated an association with RRT initiation in this cohort.
Abstract

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