Condition-Specific Comorbidity Index May Improve Accuracy

Condition-specific index may give more sensitive hospital results than Deyo Comorbidity Index

THURSDAY, May 5 (HealthDay News) -- A condition-specific comorbidity index may be significantly better than the commonly used Deyo Comorbidity Index for adjusting mortality, morbidities, and hospital disposition measures, according to a study published in the April 20 issue of Spine.

Adam P. Goode, D.P.T., P.T., from Duke University in Durham, N.C, and colleagues investigated the effect of risk-adjustment methods on mortality and morbidity between teaching and nonteaching facilities, particularly in cases of perioperative spine infection after spinal surgery. They also developed a condition-specific risk-adjustment index, using data from the Nationwide Inpatient Sample (NIS), and evaluated this index against the Deyo Comorbidity Index, comparing them for routine discharge, length of stay, death, and total hospital charges, which were stratified according to the teaching status of each hospital.

The investigators identified 23,846 perioperative spinal infection events between 1988 and 2007 in 1,212,241 procedures from the NIS database. The condition-specific index included 23 diagnoses. There were significant variations between the Deyo and condition-specific index in total charges and length of stay at nonteaching hospitals, and in death, length of stay, and total charges for teaching hospitals.

"The findings suggest that the condition-specific index is more sensitive for adjusting mortality, morbidities, and hospital disposition measures, such as length of stay and total charges, but is similar to the Deyo Comorbidity Index in adjusting for mortality for nonteaching hospitals," the authors write.

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