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J Clin Epidemiol. 2006 Mar;59(3):265-73.

Charlson scores based on ICD-10 administrative data were valid in assessing comorbidity in patients undergoing urological cancer surgery.

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1
Clinical Effectiveness Unit, The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE, United Kingdom.

Abstract

BACKGROUND AND OBJECTIVES:

Adjustment for comorbidity is an essential component of any observational study comparing outcomes. We evaluated the validity of the Charlson comorbidity score based on ICD-10 codes in patients undergoing urological cancer surgery within an English administrative database.

STUDY DESIGN AND SETTING:

Patients who underwent radical urological cancer surgery between 1998 and 2002 in the English National Health Service were identified from the Hospital Episode Statistics database (N = 20,138). ICD-9-CM codes defining comorbid diseases according to the Deyo and Dartmouth-Manitoba adaptations of the Charlson comorbidity score were translated into ICD-10 codes.

RESULTS:

Charlson scores derived by the ICD-10 translation of the Deyo and Dartmouth-Manitoba adaptations were identical in 16,623 patients (83%; kappa = .63). For both adaptations, ICD-10 scores increased with age, were higher in patients admitted on an emergency basis, and predicted short-term outcome. Addition of either the ICD-10 Charlson Deyo or Dartmouth-Manitoba score to risk models containing age and sex to predict in-hospital mortality resulted in a better model fit but only in small improvements of the predictive power.

CONCLUSION:

The ICD-10 translations of the Deyo and Dartmouth-Manitoba adaptations performed similarly in risk models predicting hospital mortality following urological cancer surgery. Adjustment for comorbidity over and above age and sex alone does not seem to provide a large improvement.

PMID:
16488357
DOI:
10.1016/j.jclinepi.2005.07.015
[Indexed for MEDLINE]
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