Elixhauser Comorbidity Measure is Superior to Charlson Comorbidity Index In-Predicting Hospital Complications Following Elective Posterior Cervical Decompression and Fusion.

Autor: Maron SZ; Department of Orthopedics, Mount Sinai Hospital, New York, New York, USA. Electronic address: samuel.maron@icahn.mssm.edu., Neifert SN; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Ranson WA; Department of Orthopedics, Mount Sinai Hospital, New York, New York, USA., Nistal DA; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Rothrock RJ; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Cooke P; Department of Orthopedics, Mount Sinai Hospital, New York, New York, USA., Lamb CD; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Cho SK; Department of Orthopedics, Mount Sinai Hospital, New York, New York, USA; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Caridi JM; Department of Orthopedics, Mount Sinai Hospital, New York, New York, USA; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Jun; Vol. 138, pp. e26-e34. Date of Electronic Publication: 2020 Feb 14.
DOI: 10.1016/j.wneu.2020.01.141
Abstrakt: Objective: The predictive ability of Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) have been compared in orthopedic and gastrointestinal surgery; however, their predictive ability for complications secondary to spine surgery and posterior cervical decompression and fusion (PCDF) specifically is understudied. This study examines the predictive ability of the ECI and CCI for complications and morbidity following PCDF.
Methods: ECI and CCI were retrospectively computed for all PCDF cases in the National Inpatient Sample database from 2013 to 2014 and complications or morbidity were identified. C-statistics were used to analyze ECI and CCI predictive ability in a range of complications and compared with a base comorbidity model that included age, sex, race, and primary payer.
Results: PCDF was performed in 46,700 hospitalizations between 2013 and 2014. The complications for which ECI was found to be a significantly better predictor included airway complications (69.16% superior to CCI), hemorrhagic anemia (79.04% superior), cardiac arrest (72.39% superior), pulmonary embolism (83.01% superior), sepsis (62.44% superior), septic shock (78.90% superior), urinary tract infection (63.53% superior), death (74.28% superior), any minor complication (75% superior), any major complication (133% superior), and any complication at all (63.72% superior). The complications for which neither the ECI Index nor the CCI proved superior were acute kidney injury, myocardial infarction, cerebrovascular accident, deep vein thrombosis, pneumonia, wound dehiscence, and superficial surgical-site infection following PCDF.
Conclusions: ECI showed superior predictive ability to the CCI in predicting 8 of the 18 complications that were analyzed and inferior in none.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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