Assessing the ability of comorbidity indexes to capture comorbid disease in the inpatient rehabilitation spinal cord injury population

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J84845

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2020 , 101, 10, 1731-1738

Publication Website:

Abstract:

Study examined whether commonly used comorbidity indexes capture comorbidities in the acute traumatic and nontraumatic spinal cord injury (SCI) inpatient rehabilitation population. Data were obtained from the Uniform Data System for Medical Rehabilitation for 66,235 adults with SCI discharged from 833 inpatient rehabilitation facilities. International Classification of Diseases-10th Revision-Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes: Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and Centers for Medicare and Medicaid Services (CMS) comorbidity tiers. The comorbidity codes that occurred with greater than 1 percent frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. Of the total study population, 39,285 (59.3 percent) were men and 11,476 (17.3 percent) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with greater than 1 percent frequency. The Deyo-Charlson comorbidity index, the Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4, 29.4, and 66.1 percent, respectively, of the discharges in the study; 28.8 percent of the discharges did not have any comorbidities captured by any of the comorbidity indexes. The findings indicate that commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. The authors conclude that alternative measures may be needed to capture the complexity of this population.

Author(s):