Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Spinal Cord Injury Population
| Autor: | Sameer Siddiqui, Jeffrey C. Schneider, Chloe Slocum, Ross Zafonte, Richard Goldstein, Donna Huang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty medicine.medical_treatment Population Physical Therapy Sports Therapy and Rehabilitation Comorbidity Rehabilitation Centers 03 medical and health sciences 0302 clinical medicine Sex Factors mental disorders medicine Health Status Indicators Humans education Spinal cord injury Spinal Cord Injuries Aged Retrospective Studies Aged 80 and over education.field_of_study Inpatients Rehabilitation business.industry Age Factors Neurological Rehabilitation Middle Aged medicine.disease Confidence interval United States Cross-Sectional Studies Socioeconomic Factors Emergency medicine Population study Female 0305 other medical science business Medicaid 030217 neurology & neurosurgery Inpatient rehabilitation |
| Zdroj: | Archives of physical medicine and rehabilitation. 101(10) |
| ISSN: | 1532-821X |
| Popis: | Objective To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. Design Retrospective cross-sectional study. Participants Data were obtained from the Uniform Data System for Medical Rehabilitation from October 1, 2015 to December 31, 2017 for adults with spinal cord injury (SCI) (Medicare-established Impairment Group Codes 04.110-04.230, 14.1, 14.3). This study included SCI discharges (N=66,235) from 833 inpatient rehabilitation facilities. Main Outcome Measures International Classification of Diseases–10th Revision–Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, CMS comorbidity tiers). The comorbidity codes that occurred with >1% frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. Results Of the total study population, 39,285 (59.3%) were men and 11,476 (17.3%) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with >1% frequency. The Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4% (95% confidence interval, 58.08%-58.84%), 29.4% (29.07%-29.76%), and 66.1% (65.73%-66.46%) of the discharges in our study, respectively, and 28.8% (28.42%-29.11%) of the discharges did not have any comorbidities captured by any of the comorbidity indexes. Conclusion Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. This work suggests that alternative measures may be needed to capture the complexity of this population. |
| Databáze: | OpenAIRE |
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