Elixhauser Comorbidity Measure is Superior to Charlson Comorbidity Index In-Predicting Hospital Complications Following Elective Posterior Cervical Decompression and Fusion

Maron, Samuel Z.; Neifert, Sean N; Ranson, William A.; Nistal, Dominic A; Rothrock, Robert J.; Cooke, Peter V.; Lamb, Colin D.; Cho, Samuel K.; Caridi, John M.

doi:10.1016/j.wneu.2020.01.141

Cited by 35 publications

(18 citation statements)

References 40 publications

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“…Welch’s t -tests were used for comparison of in-hospital LOS and costs of care following the index procedure between the matched cohorts. To determine the association of alcohol use disorder on medical- and implant-related complications, multivariate logistic regression analyses were performed for calculation of the odds ratio (OR) and 95% confidence interval (95% CI) adjusting for age, sex, geographic region, and Elixhauser Comorbidity Index (ECI) 27) .…”

Section: Methodsmentioning

confidence: 99%

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty

Horn

Diamond

et al. 2021

Hip & Pelvis

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Purpose Alcohol use disorder is a leading mental health disorder in the United States. Few studies evaluating the association of alcohol use disorder following primary total hip arthroplasty (THA) have been reported. Therefore, the purpose of this study was to determine whether patients with alcohol use disorder undergoing primary THA have higher rates of: 1) in-hospital lengths of stay (LOS); 2) complications (medical/implant-related); and 3) costs. Materials and Methods Using a nationwide claims database from January 1st, 2005 to March 31st, 2014, patients with alcohol use disorder undergoing primary THA were identified and matched to a comparison group according to age, sex, and various comorbidities, resulting in 230,467 patients who were included in the study (n=38,416) and a matched-cohort (n=192,051). Outcomes of interest included comparison of LOS, 90-day medical and 2-year implant-related complications, and costs. A P -value less than 0.002 was considered statistically significant. Results Patients with alcohol use disorder had longer in-hospital LOS (4 days vs 3 days; P <0.0001) as well as higher frequency and odds ratio (OR) of 90-day medical (45.94% vs 12.25%; OR, 2.89; P <0.0001) and 2-year implant-related complications (17.71% vs 8.46%; OR, 1.97; P <0.0001). Patients in the study group incurred higher 90-day costs of care ($17,492.63 vs $14,921.88; P <0.0001). Conclusion With the growing prevalence of alcohol use disorder in the United States, the current investigation can be utilized to evaluate the need for interventions prior to THA which can potentially minimize the rates of morbidity and mortality within this population.

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Section: Methodsmentioning

confidence: 99%

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty

Horn

Diamond

et al. 2021

Hip & Pelvis

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“…The ECI is a well-known risk adjustment model and has been shown to outperform the Charlson Comorbidity Index in predicting in-hospital outcomes. [22] In the current report, ECI demonstrated acceptable accuracy in predicting in-hospital mortality, complications, LOS and cost and the addition of JHACG-FI to ECI improved the predictive model, in all outcomes except mortality. The improvement in prediction performance was likely observed given that JHACG-FI captured domains of frailty that did not overlap with comorbidities measured by ECI, as the JHACG-FI was observed to be an independent predictor of outcomes when controlled for ECI.…”

Section: Discussionmentioning

confidence: 56%

“…[14][15][16] Of the two, the ECI was shown to more effectively discriminate in-hospital outcomes for a variety of surgical cohorts, including patients undergoing spine surgery. [17][18][19][20][21][22] The predictive performance of ECI has not been established in surgical candidates with metastatic spine disease.…”

Section: Introductionmentioning

confidence: 99%

The performance of frailty in predictive modeling of short-term outcomes in the surgical management of metastatic tumors to the spine

et al. 2022

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“…The regression model calculated odds-ratios (OR) and their respective 95% confidence intervals (95%CI) adjusted for age, sex, geographic region, and Elixhauser-Comorbidity Index (ECI). While the Charlson-Comorbidity Index (CCI) has historically been used for observational studies, the current investigation relied on ECI as an adjusting covariate as ECI has been shown not to be only superior to CCI, but also to contain nearly twice as many comorbid conditions, ensuring additional covariate adjustment within the data analyses [ 20 , 21 ]. Due to the ease of finding statistical differences with large administrative claims databases, a Bonferroni-correction was performed to reduce the probability of a type I error, and an alpha-value less than 0.002 was utilized as the threshold to determine statistical significance in the study.…”

Section: Data Analysesmentioning

confidence: 99%

The association of iron deficiency anemia and perioperative complications following revision total knee arthroplasty

et al. 2022

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Background Recent studies show an increase in the prevalence of iron deficiency anemia (IDA) worldwide and a concomitant rise in the number of revision total knee arthroplasty (RTKA). The literature evaluating the association between IDA and perioperative outcomes following RTKA are limited. Therefore, the purpose of this study was to determine whether IDA patients undergoing RTKA have higher rates of (1) in-hospital lengths of stay (LOS), (2) complications; and (3) costs. Methods Using International Classification of Disease, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT), a retrospective query was performed from January 1st, 2005 to March 31st, 2014. The inclusion criteria consisted of those patients who have IDA undergoing RTKA. Study group patients were 1:5 ratio matched to a comparison cohort by age, sex, and various comorbidities: coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, hyperlipidemia, hypertension, obesity, and tobacco use, yielding a total of 106,534 patients within the study (n = 17,784) and control (n = 88,750) cohorts. Outcomes assessed included: in-hospital LOS, costs of care, and medical complications. Multivariate Logistic regression analyses were used to calculate the odds-ratios (OR) and respective 95% confidence intervals (95%CI). Welch’s t-tests were used to compare in-hospital LOS and costs of care. Following Bonferroni-correction, a P-value less than 0.001 was considered statistically significant. Results IDA patients undergoing RTKA were found to have significantly higher in-hospital LOS (4-days vs. 3-days, P < 0.0001). Additionally, IDA patients were found to have significantly higher odds (OR) of medical complications (OR: 5.29, P < 0.0001) such as: pneumonia (OR: 6.86, P < 0.0001), respiratory failures (OR: 5.95, P < 0.0001), myocardial infarctions (OR: 4.31, P < 0.0001) and other complications. Furthermore, IDA patients incurred significantly higher day of surgery ($16,976.01 vs. $14,515.81, P < 0.0001) and 90-day costs ($22,548.71 vs. $16,819.15, P < 0.0001). Conclusion The study demonstrated IDA patients undergoing RTKA have higher rates of in-hospital LOS, costs of care, and medical complications. Orthopedic surgeons and other healthcare professionals can use this information to adequately educate these patients of the potential complications following their procedure.

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Elixhauser Comorbidity Measure is Superior to Charlson Comorbidity Index In-Predicting Hospital Complications Following Elective Posterior Cervical Decompression and Fusion

Cited by 35 publications

References 40 publications

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty

The performance of frailty in predictive modeling of short-term outcomes in the surgical management of metastatic tumors to the spine

The association of iron deficiency anemia and perioperative complications following revision total knee arthroplasty

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