Summary Elixhauser Comorbidity Score Developed for Use in Older Adults

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Unclear whether the S-Elixhauser comorbidity score offers an advantage over other similar measures

TUESDAY, Sept. 13, 2022 (HealthDay News) — The summary Elixhauser (S-Elixhauser) comorbidity score is well calibrated and internally validated, but has no clear advantage over other comorbidity indices, according to a study published online Sept. 13 in the Annals of Internal Medicine.

Hemalkumar B. Mehta, Ph.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues conducted a retrospective cohort study involving 899,844 persons hospitalized in 2018 and three disease-specific hospitalized cohorts to develop the S-Elixhauser comorbidity score. To predict 30-day, in-hospital, and one-year mortality, weights were derived for 38 comorbidities.

The researchers found that the S-Elixhauser score was well calibrated and validated internally, with C-statistics of 0.705, 0.654, and 0.743 for predicting 30-day mortality, in-hospital mortality, and one-year mortality, respectively. In external validation of other comorbidity indices, the C-statistic was 0.711, 0.688, 0.696, and 0.690 for the individual Elixhauser comorbidity indicators, the Agency for Healthcare Research and Quality (AHRQ) Elixhauser score, the Charlson comorbidity indicators, and the Charlson summary score, respectively, for 30-day mortality. The discrimination of the S-Elixhauser score in predicting 30-day mortality ranged from 0.657 to 0.732 in three disease-specific populations.

“Validation and comparative performance of the S-Elixhauser score in an external population is required to determine its utility in measuring comorbidities among older adults and whether there are instances where its use might be preferable to the AHRQ Elixhauser and Charlson summary scores,” the authors write.

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