Zhang, F, Chiu, Y, Ensor, J ORCID: https://orcid.org/0000-0001-7481-0282, Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, Peat, G ORCID: https://orcid.org/0000-0002-9008-0184 and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2021) Elixhauser outperformed Charlson comorbidity index in prognostic value after ACS: insights from a national registry. Journal of Clinical Epidemiology.

[img] Text
Comparison paper_Final.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (84kB)
[img] Text
Comparison_letter for reviewers' comments.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (31kB)
[img] Text
Supplementary table 1-4_Revised.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (31kB)
[img] Text
Main table 3_AIC BIC.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (17kB)
[img] Text
Main table 2_C statistic.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (18kB)
[img] Text
Main table 1_Basic.docx - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (20kB)
[img] Image
Fig.2_AIC BIC.tif - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (2MB)
[img] Image
Fig.1_C statistic.tif - Accepted Version
Restricted to Repository staff only until 27 August 2022.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (2MB)

Abstract

OBJECTIVE: To compare the performance of risk adjustment models using the Elixhauser and Charlson comorbidity scores in predicting in-hospital outcomes of ACS patients from a nationwide administrative database. STUDY DESIGN AND SETTING: All hospitalisations for ACS in the United States between 2004 and 2014 (n=7,201,900) were retrospectively analysed. We used ECS and CCI score based on ICD-9 codes to define comorbidity variables. Logistic regression models were fitted to three in-hospital outcomes, including mortality, Major Acute Cardiovascular & Cerebrovascular Events (MACCE) and bleeding. The prognostic values of ECS and CCI after adjusting for known confounders, were compared using the C-statistic, Akaike information criterion (AIC) and Bayesian information criterion (BIC). RESULTS: The statistical performance of models predicting all in-hospital outcomes demonstrated that the ECS had superior prognostic value compared to the CCI, with higher C-statistics and lower AIC and BIC values associated with the former. CONCLUSION: This is the first study that compared the prognostic value of the ECS and CCI scores in predicting multiple ACS outcomes, based on their scoring systems. Better discrimination and goodness of fit was achieved with the Elixhauser method across all in-hospital outcomes studied.

Item Type: Article
Additional Information: The final version of this accepted manuscript is available directly from the publishers. Please refer to any relevant terms and conditions.
Uncontrolled Keywords: acute coronary syndrome; comorbidity index; Charlson Score; Elixhauser score; model performance; model comparison
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 16 Sep 2021 07:56
Last Modified: 16 Sep 2021 07:56
URI: https://eprints.keele.ac.uk/id/eprint/10038

Actions (login required)

View Item View Item