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elixhauser comorbidity index

Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
Amit Kumar, Amol M Karmarkar, James E Graham, Linda Resnik, Alai Tan, Anne Deutsch, Kenneth J Ottenbacher
BACKGROUND: Information regarding the association of comorbidity indices with readmission risk for older adults receiving postacute care is limited. The purpose of this study was to compare the discriminatory ability of five comorbidity indices in predicting 30-day all-cause hospital readmission following discharge to the community from postacute inpatient rehabilitation facilities (IRF). METHODS: The sample included Medicare fee-for-service beneficiaries with stroke, lower extremity joint replacement, and fracture, discharged from IRF in 2011 (N = 75,582)...
August 4, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Martin I Sigurdsson, Nicholas T Longford, Mahyar Heydarpour, Louis Saddic, Tzuu-Wang Chang, Amanda A Fox, Charles D Collard, Sary Aranki, Prem Shekar, Stanton K Shernan, Jochen D Muehlschlegel, Simon C Body
BACKGROUND: Studies of the effects of postoperative atrial fibrillation (poAF) on long-term survival are conflicting, likely because of comorbidities that occur with poAF and the patient populations studied. Furthermore, the effects of poAF duration on long-term survival are poorly understood. METHODS: We utilized a prospectively collected database on outcomes of cardiac surgery at a large tertiary care institution between August 2001 and December 2010 with survival follow-up through June 2015 to analyze long-term survival of patients with poAF...
July 14, 2016: Annals of Thoracic Surgery
Shirley L Shih, Ross Zafonte, David W Bates, Paul Gerrard, Richard Goldstein, Jacqueline Mix, Paulette Niewczyk, S Ryan Greysen, Lewis Kazis, Colleen M Ryan, Jeffrey C Schneider
OBJECTIVES: Functional status is associated with patient outcomes, but is rarely included in hospital readmission risk models. The objective of this study was to determine whether functional status is a better predictor of 30-day acute care readmission than traditionally investigated variables including demographics and comorbidities. DESIGN: Retrospective database analysis between 2002 and 2011. SETTING: 1158 US inpatient rehabilitation facilities...
October 1, 2016: Journal of the American Medical Directors Association
Raghu R Seethala, Kevin Blackney, Peter Hou, Haytham M A Kaafarani, Daniel Dante Yeh, Imoigele Aisiku, Christopher Tainter, Marc deMoya, David King, Jarone Lee
BACKGROUND: Based on the current literature, it is unclear whether advanced age itself leads to higher mortality in critically ill patients or whether it is due to the greater number of comorbidities in the elderly patients. We hypothesized that increasing age would increase the odds of short-term and long-term mortality after adjusting for baseline comorbidities in intensive care unit (ICU) patients. METHODS: We performed a retrospective cohort study of 57 160 adults admitted to any ICU over 5 years at 2 academic tertiary care centers...
July 11, 2016: Journal of Intensive Care Medicine
Meera N Harhay, Alexander S Hill, Wei Wang, Orit Even-Shoshan, Adam S Mussell, Roy D Bloom, Harold I Feldman, Jason H Karlawish, Jeffrey H Silber, Peter P Reese
BACKGROUND: Early rehospitalization (<30 days) after discharge from kidney transplantation (KT) is associated with poor outcomes. We explored summary metrics of pre-transplant health status that may improve the identification of KT recipients at risk for early rehospitalization and mortality after transplant. MATERIALS AND METHODS: We performed a retrospective cohort study of 8,870 adult (≥ 18 years) patients on hemodialysis who received KT between 2000 and 2010 at United States transplant centers...
2016: PloS One
Lindsay Ramey, Richard Goldstein, Ross Zafonte, Colleen Ryan, Lewis Kazis, Jeffrey Schneider
OBJECTIVE: Few studies have focused on 30-day readmission rates in inpatient rehabilitation facilities (IRFs) and factors that contribute to this. The purpose of this study was to examine the variation in 30-day readmission rates among medically complex patients at IRFs nationally and explore how patient and facility characteristics are associated with this variation. DESIGN: Retrospective review of an administrative database. SETTING: IRFs throughout the United States...
August 1, 2016: Journal of the American Medical Directors Association
Afshin A Anoushiravani, Zain Sayeed, Monique C Chambers, Theodore J Gilbert, Steven L Scaife, Mouhanad M El-Othmani, Khaled J Saleh
BACKGROUND: Poor nutritional status is a preventable condition frequently associated with low body mass index (BMI). The purpose of this study is to comparatively analyze low (≤19 kg/m(2)) and normal (19-24.9 kg/m(2)) BMI cohorts, examining if a correlation between BMI, postoperative outcomes, and resource utilization exists. METHODS: Discharge data from the 2006-2012 National Inpatient Sample were used for this study. A total of 3550 total hip arthroplasty (THA) and 1315 total knee arthroplasty (TKA) patient samples were divided into 2 cohorts, underweight (≤19 kg/m(2)) and normal BMI (19-24...
July 2016: Journal of Arthroplasty
Costas Sideris, Mohammad Pourhomayoun, Haik Kalantarian, Majid Sarrafzadeh
Disease and symptom diagnostic codes are a valuable resource for classifying and predicting patient outcomes. In this paper, we propose a novel methodology for utilizing disease diagnostic information in a predictive machine learning framework. Our methodology relies on a novel, clustering-based feature extraction framework using disease diagnostic information. To reduce the data dimensionality, we identify disease clusters using co-occurrence statistics. We optimize the number of generated clusters in the training set and then utilize these clusters as features to predict patient severity of condition and patient readmission risk...
June 1, 2016: Computers in Biology and Medicine
Abiram Bala, Colin T Penrose, Thorsten M Seyler, Timmothy R Randell, Samuel S Wellman, Michael P Bolognesi
BACKGROUND: Isolated case reports in the literature describe systemic neurologic side effects associated with metal-on-metal (MOM) bearing surfaces, yet the incidence of these effects have not been evaluated beyond individual cases. The purpose of this study was to compare new diagnoses of these side effects described in isolated cases in large patient cohorts of MOM vs metal on polyethylene (MOP). METHODS: We queried the entire Medicare database from 2005 to 2012...
September 2016: Journal of Arthroplasty
Zain Sayeed, Afshin A Anoushiravani, Monique C Chambers, Theodore J Gilbert, Steven L Scaife, Mouhanad M El-Othmani, Khaled J Saleh
BACKGROUND: As orthopedic surgeons search for objective measures that predict total joint arthroplasty (TJA) outcomes, body mass index may aid in risk stratification. The purpose of this study was to compare in-hospital TJA outcomes and resource consumption amongst underweight (body mass index ≤19 kg/m(2)) and morbidly obese patients (≥40 kg/m(2)). METHODS: Discharge data from 2006 to 2012 National Inpatient Sample were used for this study. A total of 1503 total hip arthroplasty (THA) and 956 total knee arthroplasty (TKA) patients were divided into 2 cohorts, underweight (≤19 kg/m(2)) and morbidly obese (≥40 kg/m(2))...
October 2016: Journal of Arthroplasty
Li-Ting Kao, Yu-Lung Chiu, Herng-Ching Lin, Hsin-Chien Lee, Shiu-Dong Chung
OBJECTIVES: The health of physicians is an important topic which needs to be addressed in order to provide the best quality of patient care. However, there are few studies on the prevalence of chronic diseases among physicians. In this study, we explored the prevalence of chronic diseases among physicians and compared the probability of chronic diseases between physicians and the general population using a population-based data set in Taiwan. STUDY DESIGN: A cross-sectional study...
2016: BMJ Open
Hemalkumar B Mehta, Sneha D Sura, Manvi Sharma, Michael L Johnson, Taylor S Riall
OBJECTIVES: To compare the performance of the health-related quality of life-comorbidity index (HRQoL-CI) with the diagnosis-based Charlson, Elixhauser, and combined comorbidity scores and the prescription-based chronic disease score (CDS) in predicting HRQoL in Agency of Healthcare Research and Quality priority conditions (asthma, breast cancer, diabetes, and heart failure). METHODS: The Medical Expenditure Panel Survey (2005 and 2007-2011) data was used for this retrospective study...
May 2016: Medical Care
Joseph E Tanenbaum, Daniel Lubelski, Benjamin P Rosenbaum, Nicolas R Thompson, Edward C Benzel, Thomas E Mroz
BACKGROUND CONTEXT: Atlantoaxial fusion is used to correct atlantoaxial instability that is often secondary to traumatic fractures, Down syndrome, or rheumatoid arthritis. The effect of age and comorbidities on outcomes following atlantoaxial fusion is unknown. PURPOSE: This study aimed to better understand trends and predictors of outcomes and charges following atlantoaxial fusion and to identify confounding variables that should be included in future prospective studies...
May 2016: Spine Journal: Official Journal of the North American Spine Society
Jürgen Stausberg, Stefan Hagn
Measures of morbidity and comorbidity are frequently used for the control of confounding, particularly in health services research. Several proposals for those measures are defined with ICD-coded diagnoses available in hospital routine data. However, a measure that makes use of the ICD structure is missing. Objective of this work was to elaborate the power of the ICD structure for defining morbidity and comorbidity measures. Routine data from three German hospitals with inpatients discharged 2008 were used for model development; routine data from 36 German hospitals with inpatients admitted and discharged 2010 were used for model evaluation...
2015: PloS One
Ching-Chih Lee, Hsu-Chueh Ho, Yu-Chieh Su, Po-Chun Chen, Chia-Hui Yu, Ching-Chieh Yang
OBJECTIVE: Several comorbid measures have been developed and demonstrated the predictive ability for cancer mortality. We conducted a retrospective study on oral squamous cell carcinoma (OSCC) patients to compare the Charlson comorbidity index score (CCIS) to the Elixhauser comorbidity index score (ECIS). METHODS: Newly diagnosed OSCC patients (n=232) post major surgery with or without adjuvant therapy were identified from the cancer registry database between 2006 and 2011...
June 2016: Auris, Nasus, Larynx
Hemalkumar B Mehta, Francesca Dimou, Deepak Adhikari, Nina P Tamirisa, Eric Sieloff, Taylor P Williams, Yong-Fang Kuo, Taylor S Riall
INTRODUCTION: The optimal methodology for assessing comorbidity to predict various surgical outcomes such as mortality, readmissions, complications, and failure to rescue (FTR) using claims data has not been established. OBJECTIVE: Compare diagnosis-based and prescription-based comorbidity scores for predicting surgical outcomes. METHODS: We used 100% Texas Medicare data (2006-2011) and included patients undergoing coronary artery bypass grafting, pulmonary lobectomy, endovascular repair of abdominal aortic aneurysm, open repair of abdominal aortic aneurysm, colectomy, and hip replacement (N=39,616)...
February 2016: Medical Care
Amit Kumar, James E Graham, Linda Resnik, Amol M Karmarkar, Anne Deutsch, Alai Tan, Soham Al Snih, Kenneth J Ottenbacher
BACKGROUND: Medicare data from acute hospitals do not contain information on functional status. This lack of information limits the ability to conduct rehabilitation-related health services research. OBJECTIVE: The purpose of this study was to examine the associations between 5 comorbidity indexes derived from acute care claims data and functional status assessed at admission to an inpatient rehabilitation facility (IRF). Comorbidity indexes included tier comorbidity, Functional Comorbidity Index (FCI), Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Hierarchical Condition Category (HCC)...
February 2016: Physical Therapy
Abiram Bala, Colin T Penrose, Thorsten M Seyler, Richard C Mather, Samuel S Wellman, Michael P Bolognesi
INTRODUCTION: Total Knee Arthroplasty (TKA) is an important treatment for posttraumatic arthritis (PTA), but evidence on outcomes is sparse. The purpose of this study was to evaluate the impact of PTA versus primary osteoarthritis (OA) on postoperative outcomes after TKA. METHODS: We queried the entire Medicare database from 2005 to 2012. International Classification of Diseases, 9th revision and Current Procedural Terminology codes were used to identify the procedure, indication, and complications...
December 2015: Knee
Karim S Ladha, Kevin Zhao, Sadeq A Quraishi, Tobias Kurth, Matthias Eikermann, Haytham M A Kaafarani, Eric N Klein, Raghu Seethala, Jarone Lee
OBJECTIVES: Our primary objective was to compare the utility of the Deyo-Charlson Comorbidity Index (DCCI) and Elixhauser-van Walraven Comorbidity Index (EVCI) to predict mortality in intensive care unit (ICU) patients. SETTING: Observational study of 2 tertiary academic centres located in Boston, Massachusetts. PARTICIPANTS: The study cohort consisted of 59,816 patients from admitted to 12 ICUs between January 2007 and December 2012. PRIMARY AND SECONDARY OUTCOME: For the primary analysis, receiver operator characteristic curves were constructed for mortality at 30, 90, 180, and 365 days using the DCCI as well as EVCI, and the areas under the curve (AUCs) were compared...
2015: BMJ Open
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