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Validation and adaptation of the Charlson Comorbidity Index using administrative data from the Colombian health

Henry Oliveros1,2, Giancarlo Buitrago3

  • 1PhD Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics. (PhD cand.), Pontificia Universidad Javeriana, Bogotá, Colombia henryor@unisabana.edu.co.

BMJ Open
|March 24, 2022
PubMed

Insights

The Charlson Comorbidity Index (CCI) was validated for Colombian hospital patients. A modified CCI showed adequate predictive value for 1-year mortality, supporting its use in Colombia.

Area of Science:

  • Health Services Research
  • Epidemiology
  • Medical Informatics

Background:

  • The Charlson Comorbidity Index (CCI) is a widely used tool for predicting mortality.
  • Validating the CCI in diverse populations, such as Colombia, is crucial for its accurate application.
  • Administrative databases offer a valuable resource for large-scale health research.

Purpose of the Study:

  • To validate the Charlson Comorbidity Index (CCI) for the Colombian population.
  • To assess the predictive value of different CCI versions for 1-year mortality.
  • To adapt and evaluate a modified CCI for Colombian patients.

Main Methods:

  • Retrospective cohort study using administrative data from Colombian health insurers (2016).
  • Inclusion of 3,849,849 adult patients admitted to hospitals.
  • Analysis of 1-year mortality using death certificates and comparison of CCI model calibration and discrimination.

Main Results:

  • The study analyzed 3,849,849 patients, with 46,429 deaths within 1 year (1.21%).
  • Three versions of the CCI demonstrated strong discriminatory power for 1-year mortality.
  • The area under the ROC curve ranged from 0.906 to 0.909 across the tested CCI models.

Conclusions:

  • Adapting the CCI using 14 predictive variables resulted in adequate 1-year mortality prediction for hospitalized patients.
  • The modified CCI demonstrates robust predictive value in the Colombian population.
  • These findings support the implementation of a modified CCI for clinical and research purposes in Colombia.
Abstract

Keywords:
epidemiologyinternal medicinepublic health

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