A Comprehensive Prognostic Index to Predict Survival Based on Multiple Comorbidities
A Focus on Breast Cancer
Bibliographic Data
| ID | 9099940 |
|---|---|
| Authors | Steven T Fleming (Central Baptist Hospital, corresponding author), Amita Rastogi (Grant Medical Center), Alexei Dmitrienko (Grant Medical Center), Kjell D Johnson (Grant Medical Center) |
| Year | 1999 |
| Volume | 37 |
| Issue | 6 |
| Pages | 601-614 |
| Publication date | 1999-06-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-199906000-00009 |
| PMID | 10386572 |
| OpenAlex | W2087419523 |
| Language | EN |
| Citations received | 5 |
| References cited | 28 |
BACKGROUND: The presence of comorbidities often influences clinical decision-making, although many studies exclude patients with comorbid disease for the sake of analysis. OBJECTIVES: The purpose of this study was to develop a Comprehensive Prognostic Index (CPI), designed specifically for breast cancer patients. RESEARCH DESIGN: This study linked Medicare claims with the Kentucky Cancer Registry and developed two models based on 1 year survival; one focused on deaths caused by breast cancer and the other on deaths from all causes. Comorbidities were derived from inpatient and ambulatory claims for up to 2 years before the diagnosis of breast cancer. SUBJECTS: Subjects included a cohort of 848 elderly women first diagnosed with breast cancer in the state of Kentucky in 1993. MEASURES: Each model identified the comorbidities specific to breast cancer that were detrimental to survival, and generated a refined comorbidity index. The CPI integrated these measures with age and stage of cancer into a comprehensive prognostic index. RESULTS: Nearly two-thirds of the patients had evidence of at least one comorbidity. Survival rates decreased with age, more advanced stage, and increased comorbidity burden, as expected. The interaction of comorbidity burden with either age or stage was particularly strong for the older and more advanced stage of cancer. CONCLUSIONS: The CPI could be a useful tool in breast cancer intervention studies and a prognostic aid for clinicians
Breast cancer · Cancer · Cancer registry · Cancer survival · Cohort · Cohort study · Comorbidity · Disease · Proportional hazards model · Stage (stratigraphy) · Survival analysis · Breast Cancer Treatment Studies · Cancer survivorship and care · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Oncology
Developing a Claim-based Version of the ACE-27 Comorbidity Index
Assessing Comorbidity Using Claims Data
In Search of the Perfect Comorbidity Measure for Use With Administrative Claims Data
Comorbidity as a Predictor of Stage of Illness for Patients With Breast Cancer
Comparison of Comorbidity Indices for Patients With Head and Neck Cancer
Presentation adapting a clinical comorbidity index for use with ICD-9-CM administrative data
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
A new method of classifying prognostic comorbidity in longitudinal studies
Interpreting the Health Care Financing Administrationʼs Mortality Statistics
The Risk-Adjusted Mortality Index
The Measurement of Mortality
The Importance of Co-existent Disease in the Occurrence of Postoperative Complications and One-Year Recovery in Patients Undergoing Total Hip Replacement
| Citations per year | 0.21 |
|---|---|
| Citation span | 2002 - 2011 (10) |
| Highly cited | No |