期刊
CLINICAL EPIDEMIOLOGY
卷 11, 期 -, 页码 923-932出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/CLEP.S218697
关键词
mortality; comorbidity; follow-up studies; hospitalization/statistics and numerical data; drug prescriptions/statistics and numerical data; confounding factors
资金
- Academy of Finland [132385, 260 931]
- Cancer Society of Finland
- Pirkanmaa Hospital District Competitive Research Funding [9V065]
- Academy of Finland (AKA) [132385, 132385] Funding Source: Academy of Finland (AKA)
Purpose: To evaluate the performance of Charlson Comorbidity Index (CCI) calculated using hospitalization and medication reimbursement databases in predicting mortality. Patients and methods: Information on hospitalizations was obtained from the national Care Register for Health Care (HILMO) and on medication reimbursements and entitlements for special reimbursements for medications from the Social Insurance Institution for 77,440 men aged 56-71 years at baseline. The subjects were followed up for mortality via Statistics Finland with 20,562 deaths during a 13-year follow-up. Results: Compared to a CCI score of 0, the age-adjusted hazard ratio for all-cause mortality associated with HILMO-based CCI scores of 1, 2 and 3 or more were 2.39 (95% CI 2.29-2.49), 2.96 (95% CI 2.81-3.13) and 6.42 (95% CI 5.95-6.93) at 13 years. The C-statistic was 0.72 at 1, 0.68 at 5 and 0.66 at 13 years, with only minor improvement over age alone (0.10, 0.06 and 0.04 accordingly). Addition of medication data did not improve predictive abilities and medication-based CCI performed poorly on its own. Conclusion: The hospitalization-based CCI, as well as that based on both databases, predicts relative mortality adequately, but its discriminative ability diminishes over time. Conditions related to hospitalizations affect survival more than medications.
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