Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Burn Injury Population

Short Title:
Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Burn Injury Population
Model System:
Burn
Reference Type:
Journal Article
Accession No.:
J71471
Journal:
American Journal of Physical Medicine & Rehabilitation
Year, Volume, Issue, Page(s):
2015, vol. 1, issue , pp 373-384
Publication Website:
Abstract:
Study examined whether existing comorbidity measures capture comorbidities in the burn inpatient rehabilitation population. Data were obtained from the Uniform Data System for Medical Rehabilitation from 2002 to 2011 for adults with burn injury. International Classi?cation of Diseases, 9th Revision (ICD-9) codes were used to assess three comorbidity measures: (1) Charlson Comorbidity Index, (2) Elixhauser Comorbidity Index, and (3) Centers for Medicare and Medicaid Services Comorbidity Tiers. The number of subjects and unique comorbidity codes (frequency greater than 1 percent) captured by each comorbidity measure was calculated. The study included 5,347 patients with a median total body surface area burn decile of 20 to 29 percent, mean age of 51.6 years, and mean number of comorbidities of 7.6. There were 2,809 unique ICD-9 comorbidity codes. The Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Centers for Medicare and Medicaid Services Comorbidity Tiers did not capture 67 percent, 27 percent, and 58 percent of the subjects, respectively. There were 107 unique comorbidities that occurred with a frequency of greater than 1 percent. Of these, 67 percent were not captured in all three comorbidity measures. These findings indicate that commonly used comorbidity indexes do not re?ect the extent of comorbid disease in the burn rehabilitation population. Future work is needed to assess the need for comorbidity indexes speci?c to the inpatient rehabilitation setting.
Author(s):
Slocum CS, Goldstein R, DiVita MA, Mix J, Niewczyk P, Gerrard P, Sheridan R, Kowalske KJ, Zafonte R, Ryan CM, Schneider JC:
Author Address(es):
Participating Centers:

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