alexa Comorbidity measures for use with administrative data.
Surgery

Surgery

Journal of Surgery

Author(s): Elixhauser A, Steiner C, Harris DR, Coffey RM, Elixhauser A, Steiner C, Harris DR, Coffey RM

Abstract Share this page

Abstract OBJECTIVES: This study attempts to develop a comprehensive set of comorbidity measures for use with large administrative inpatient datasets. METHODS: The study involved clinical and empirical review of comorbidity measures, development of a framework that attempts to segregate comorbidities from other aspects of the patient's condition, development of a comorbidity algorithm, and testing on heterogeneous and homogeneous patient groups. Data were drawn from all adult, nonmaternal inpatients from 438 acute care hospitals in California in 1992 (n = 1,779,167). Outcome measures were those commonly available in administrative data: length of stay, hospital charges, and in-hospital death. RESULTS: A comprehensive set of 30 comorbidity measures was developed. The comorbidities were associated with substantial increases in length of stay, hospital charges, and mortality both for heterogeneous and homogeneous disease groups. Several comorbidities are described that are important predictors of outcomes, yet commonly are not measured. These include mental disorders, drug and alcohol abuse, obesity, coagulopathy, weight loss, and fluid and electrolyte disorders. CONCLUSIONS: The comorbidities had independent effects on outcomes and probably should not be simplified as an index because they affect outcomes differently among different patient groups. The present method addresses some of the limitations of previous measures. It is based on a comprehensive approach to identifying comorbidities and separates them from the primary reason for hospitalization, resulting in an expanded set of comorbidities that easily is applied without further refinement to administrative data for a wide range of diseases.
This article was published in Med Care and referenced in Journal of Surgery

Relevant Expert PPTs

Relevant Speaker PPTs

  • Li Yu-Jung
    Intra-maxillary Drug delivery and Bio-sensing via Dental Implant and its considerations
    PPT Version | PDF Version
  • Nicolae Bacalbasa
    The benefits of surgery for breast cancer liver metastases – a single center experience
    PPT Version | PDF Version
  • Sitanshu Sekhar Lahiri
    A novel oral formulation for cancer therapy, loaded in a slow release matrix for targeted delivery
    PPT Version | PDF Version
  • Li-Chun Tsou
    Drug delivery device strategy for patient centric therapies
    PDF Version
  • Dipesh Shah
    Compatibility assessment of a model monoclonal antibody formulation in glass and in blow-fi ll-seal (BFS) plastic vial delivery formats
    PPT Version | PDF Version
  • Stephanie Ramos
    Enhanced Delivery of Dna-Based Vaccines and Immunotherapeutics through Next-Generation Electroporation Devices
    PPT Version | PDF Version
  • Suzi Demirbag
    Indications and effectiveness of the open surgery in vesicoureteral refl ux
    PPT Version | PDF Version
  • Mehmet Ozler
    “Mehmet Ozler-Gulhane-Military-Medical-Academy-Ankara-Turkey-Pinealectomy-Initiates-the-Oxidative-Stress-Response-in-Brain-Tissue-of-Rats-Subject-to-Abdominal-Surgery”
    PPT Version | PDF Version
  • Nirmala Chauhan
    Modification of dietary fiber psyllium for use in oral insulin delivery
    PPT Version | PDF Version
  • Youngmi Jung
    TSG-6 induces liver regeneration by enhancing autophagy in mice with chronic liver damage
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Suoqin Tang
    Survivin siRNA nano particles are capable of inhibiting liver cancer cell growth both in vitro and in vivo
    PPT Version | PDF Version
  • Arshad mahmood
    TRANSPORT OF SELF-NANOEMULSIFYING DRUG DELIVERY SYSTEM (SNEDDS) ACROSS MUCUS AND CELLULAR INTERNALIZATION
    PPT Version | PDF Version
  • Wei Duan
    Cancer stem cells targeted delivery of siRNA to overcome induced chemoresistance
    PPT Version | PDF Version
  • Yung-Chih Kuo
    “Yung-Chih Kuo-National-Chung-Cheng-University-Republic-of-China-Targeting-delivery-of-etoposide-to-inhibit-the-growth-of-human-glioblastoma-multiforme-using-lactoferrin-and-folic-acid-grafted-poly(lactide-co-glycolide)-nanoparticles”
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords