Journal of Clinical Epidemiology
Journal of Clinical Epidemiology
5 years ago

The new Measuring Multimorbidity index predicted mortality better than Charlson and Elixhauser indices amongst the general population

To develop and validate an updated morbidity index for short-term mortality risk, using chronic conditions identified from routine hospital admission ICD-10 data. Study Design and Setting Retrospective cohort study of all adult New Zealand (NZ) residents at 1st Jan 2012. Participants Adult NZ residents aged 18 and over, defined by enrolment with a Primary Healthcare Organisation or accessing public healthcare in preceding year. Data were split into two datasets for index development (70%, n=2,331,645) and validation (30%, n=1,000,166). Results The M3 index was constructed using log hazard ratios for one-year mortality modelled from presence of 61 chronic conditions. Validation results were improved for the M3 index for predicting one-year mortality compared to Charlson and Elixhauser on the c-statistic (M3: 0.931, Charlson 0.921, Elixhauser 0.922; difference M3 vs Charlson = 0.010, 95% CI 0.008, 0.012; M3 vs Elixhauser = 0.009, 95% CI 0.007, 0.012) and integrated discriminative improvement (IDI: M3 vs Charlson=0.024, 95% CI 0.021, 0.026; M3 vs Elixhauser=0.024, 95% CI 0.022, 0.027). Conclusion The M3 index had improved predictive performance for one-year mortality risk over Charlson and Elixhauser indices, allowing better adjustment for mortality risk from chronic conditions. This provides an important tool for population-level analyses of health outcomes.

Publisher URL: www.sciencedirect.com/science

DOI: S0895435617304419

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.