Charlson index scores from administrative data and case-note review compared favourably in a renal disease cohort

Marjorie C Johnston; Angharad Marks; Michael A Crilly; Gordon J Prescott; Lynn M Robertson; Corri Black

doi:10.1093/eurpub/cku238

Charlson index scores from administrative data and case-note review compared favourably in a renal disease cohort

Marjorie C Johnston, Angharad Marks, Michael A Crilly, Gordon J Prescott, Lynn M Robertson, Corri Black

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Abstract

BACKGROUND: The Charlson index is a widely used measure of comorbidity. The objective was to compare Charlson index scores calculated using administrative data to those calculated using case-note review (CNR) in relation to all-cause mortality and initiation of renal replacement therapy (RRT) in the Grampian Laboratory Outcomes Mortality and Morbidity Study (GLOMMS-1) chronic kidney disease cohort.

METHODS: Modified Charlson index scores were calculated using both data sources in the GLOMMS-1 cohort. Agreement between scores was assessed using the weighted Kappa. The association with outcomes was assessed using Poisson regression, and the performance of each was compared using net reclassification improvement.

RESULTS: Of 3382 individuals, median age 78.5 years, 56% female, there was moderate agreement between scores derived from the two data sources (weighted kappa 0.41). Both scores were associated with mortality independent of a number of confounding factors. Administrative data Charlson scores were more strongly associated with death than CNR scores using net reclassification improvement. Neither score was associated with commencing RRT.

CONCLUSION: Despite only moderate agreement, modified Charlson index scores from both data sources were associated with mortality. Neither was associated with commencing RRT. Administrative data compared favourably and may be superior to CNR when used in the Charlson index to predict mortality.

Original language	English
Pages (from-to)	391-396
Number of pages	6
Journal	European Journal of Public Health
Volume	25
Issue number	3
Early online date	12 Jan 2015
DOIs	https://doi.org/10.1093/eurpub/cku238
Publication status	Published - Jun 2015

Bibliographical note

© The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

This work was supported by a grant from the Chief Scientist Office, Scotland (CZH/4/656). A grant to investigate acute renal failure from Kidney Research UK in 2004 allowed the set up of the cohort. Dr Johnston carried out the analysis for the work whilst an employee of NHS Grampian and wrote this draft of the paper whilst funded by a Clinical Academic Fellowship from the Chief Scientist office, Scotland (CAF/13/03). Dr Johnston also receives support from the Farr Institute @Scotland.

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Charlson_Manuscript v02Accepted author manuscript, 123 KB

Grampian Laboratory Outcomes Morbidity and Mortality Study (GLOMMS)
Black, C. (Creator) & Marks, A. (Creator), Grampian Data Safe Haven, 2014
http://www.abdn.ac.uk/ims/research/immunology/renal-304.php
Dataset

Cite this

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title = "Charlson index scores from administrative data and case-note review compared favourably in a renal disease cohort",

abstract = "BACKGROUND: The Charlson index is a widely used measure of comorbidity. The objective was to compare Charlson index scores calculated using administrative data to those calculated using case-note review (CNR) in relation to all-cause mortality and initiation of renal replacement therapy (RRT) in the Grampian Laboratory Outcomes Mortality and Morbidity Study (GLOMMS-1) chronic kidney disease cohort.METHODS: Modified Charlson index scores were calculated using both data sources in the GLOMMS-1 cohort. Agreement between scores was assessed using the weighted Kappa. The association with outcomes was assessed using Poisson regression, and the performance of each was compared using net reclassification improvement.RESULTS: Of 3382 individuals, median age 78.5 years, 56% female, there was moderate agreement between scores derived from the two data sources (weighted kappa 0.41). Both scores were associated with mortality independent of a number of confounding factors. Administrative data Charlson scores were more strongly associated with death than CNR scores using net reclassification improvement. Neither score was associated with commencing RRT.CONCLUSION: Despite only moderate agreement, modified Charlson index scores from both data sources were associated with mortality. Neither was associated with commencing RRT. Administrative data compared favourably and may be superior to CNR when used in the Charlson index to predict mortality.",

author = "Johnston, {Marjorie C} and Angharad Marks and Crilly, {Michael A} and Prescott, {Gordon J} and Robertson, {Lynn M} and Corri Black",

note = "{\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. This work was supported by a grant from the Chief Scientist Office, Scotland (CZH/4/656). A grant to investigate acute renal failure from Kidney Research UK in 2004 allowed the set up of the cohort. Dr Johnston carried out the analysis for the work whilst an employee of NHS Grampian and wrote this draft of the paper whilst funded by a Clinical Academic Fellowship from the Chief Scientist office, Scotland (CAF/13/03). Dr Johnston also receives support from the Farr Institute @Scotland.",

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doi = "10.1093/eurpub/cku238",

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AU - Prescott, Gordon J

AU - Robertson, Lynn M

AU - Black, Corri

N1 - © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. This work was supported by a grant from the Chief Scientist Office, Scotland (CZH/4/656). A grant to investigate acute renal failure from Kidney Research UK in 2004 allowed the set up of the cohort. Dr Johnston carried out the analysis for the work whilst an employee of NHS Grampian and wrote this draft of the paper whilst funded by a Clinical Academic Fellowship from the Chief Scientist office, Scotland (CAF/13/03). Dr Johnston also receives support from the Farr Institute @Scotland.

PY - 2015/6

Y1 - 2015/6

N2 - BACKGROUND: The Charlson index is a widely used measure of comorbidity. The objective was to compare Charlson index scores calculated using administrative data to those calculated using case-note review (CNR) in relation to all-cause mortality and initiation of renal replacement therapy (RRT) in the Grampian Laboratory Outcomes Mortality and Morbidity Study (GLOMMS-1) chronic kidney disease cohort.METHODS: Modified Charlson index scores were calculated using both data sources in the GLOMMS-1 cohort. Agreement between scores was assessed using the weighted Kappa. The association with outcomes was assessed using Poisson regression, and the performance of each was compared using net reclassification improvement.RESULTS: Of 3382 individuals, median age 78.5 years, 56% female, there was moderate agreement between scores derived from the two data sources (weighted kappa 0.41). Both scores were associated with mortality independent of a number of confounding factors. Administrative data Charlson scores were more strongly associated with death than CNR scores using net reclassification improvement. Neither score was associated with commencing RRT.CONCLUSION: Despite only moderate agreement, modified Charlson index scores from both data sources were associated with mortality. Neither was associated with commencing RRT. Administrative data compared favourably and may be superior to CNR when used in the Charlson index to predict mortality.

AB - BACKGROUND: The Charlson index is a widely used measure of comorbidity. The objective was to compare Charlson index scores calculated using administrative data to those calculated using case-note review (CNR) in relation to all-cause mortality and initiation of renal replacement therapy (RRT) in the Grampian Laboratory Outcomes Mortality and Morbidity Study (GLOMMS-1) chronic kidney disease cohort.METHODS: Modified Charlson index scores were calculated using both data sources in the GLOMMS-1 cohort. Agreement between scores was assessed using the weighted Kappa. The association with outcomes was assessed using Poisson regression, and the performance of each was compared using net reclassification improvement.RESULTS: Of 3382 individuals, median age 78.5 years, 56% female, there was moderate agreement between scores derived from the two data sources (weighted kappa 0.41). Both scores were associated with mortality independent of a number of confounding factors. Administrative data Charlson scores were more strongly associated with death than CNR scores using net reclassification improvement. Neither score was associated with commencing RRT.CONCLUSION: Despite only moderate agreement, modified Charlson index scores from both data sources were associated with mortality. Neither was associated with commencing RRT. Administrative data compared favourably and may be superior to CNR when used in the Charlson index to predict mortality.

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JF - European Journal of Public Health

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Charlson index scores from administrative data and case-note review compared favourably in a renal disease cohort

Abstract

Bibliographical note

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Grampian Laboratory Outcomes Morbidity and Mortality Study (GLOMMS)

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