Comorbid Illness is Associated with Survival and Length of Hospital Stay in Patients with Chronic Disability

A Prospective Comparison of Three Comorbidity Indices

Bibliographic Data

ID9101618
AuthorsPaula A Rochon (0000-0002-5973-4151, University of Toronto), Jeffrey N Katz (0000-0003-2104-4670, Baycrest Hospital), LINDA A MORROW, Linda Morrow (0000-0003-3252-4477, Baycrest Hospital), REGINA MCGLINCHEY-BERROTH, Regina McGlinchey‐Berroth (Baycrest Hospital), MARGARET M AHLQUIST (Baycrest Hospital), MEDHI SARKARATI (Baycrest Hospital), KENNETH L MINAKER (Baycrest Hospital)
Year1996
Volume34
Issue11
Pages1093-1101
Publication date1996-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199611000-00004
PMID8911426
OpenAlexW2080981386
LanguageEN
Citations received15
References cited33

OBJECTIVES: This study was designed to determine if comorbidity added more information than knowing only the patient's age in predicting survival and length of hospital stay. METHODS: The authors compared the relative predictive validity of three comorbidity indices: the Cumulative Illness Rating Scale, the Charlson Index, and a count of International Classification of Diseases, 9th Revision, Clinical Modification medical diagnoses in relation to survival and length of hospital stays in patients with spinal cord injury. The sample consisted of 330 longitudinally followed spinal-cord injured patients admitted between January 1989 and December 1990 who were followed for an additional 18 months. RESULTS: During the follow-up, 25 (7.5%) patients died and 249 (75.5%) were readmitted to hospital with a median of one admission (range, 1-8). The corresponding lengths of hospital stay ranged from 0 to 548 days, with a median of 7 days. CONCLUSIONS: Patients who died were not significantly older but had higher comorbidity scores. Using patients alive at the end of the follow-up period, linear regression models were fit to the data to determine if comorbidity added more information regarding length of hospital stay than knowing only the patient's age. In the model that included only age as an independent variable, there was a significant relation between age and length of stay (F(1,303) = 5.2; P = 0.012). The R2 value for this model was 0.017. In further models that included age and each of the three comorbidity scores (separately) as the independent variables, the model that included age and the Cumulative Illness Rating Scale yielded the highest R2 value (R2 = 0.062). This study is among the first to compare three different measures of comorbidity and documents that comorbidity provides more information than knowing only the patient's age in relation to survival and length of hospital stay

Comorbidity · Logistic regression · Balance, Gait, and Falls Prevention · Chronic Disease Management Strategies · Internal Medicine · Medicine · Spinal Cord Injury Research · Pediatrics

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