دورية أكاديمية

Development and validation of a multi-dimensional diagnosis-based comorbidity index that improves prediction of death in men with prostate cancer: Nationwide, population-based register study

التفاصيل البيبلوغرافية
العنوان: Development and validation of a multi-dimensional diagnosis-based comorbidity index that improves prediction of death in men with prostate cancer: Nationwide, population-based register study
المؤلفون: Westerberg, Marcus, Irenaeus, Sandra, Garmo, Hans, Stattin, Pär, Gedeborg, Rolf
المساهمون: Paci, Eugenio, Cancerfonden, Region Uppsala
المصدر: PLOS ONE ; volume 19, issue 1, page e0296804 ; ISSN 1932-6203
بيانات النشر: Public Library of Science (PLoS)
سنة النشر: 2024
المجموعة: PLOS Publications (via CrossRef)
الوصف: Assessment of comorbidity is crucial for confounding adjustment and prediction of mortality in register-based studies, but the commonly used Charlson comorbidity index is not sufficiently predictive. We aimed to develop a multidimensional diagnosis-based comorbidity index (MDCI) that captures comorbidity better than the Charlson Comorbidity index. The index was developed based on 286,688 men free of prostate cancer randomly selected from the Swedish general population, and validated in 54,539 men without and 68,357 men with prostate cancer. All ICD-10 codes from inpatient and outpatient discharges during 10 years prior to the index date were used to define variables indicating frequency of code occurrence, recency, and total duration of related hospital admissions. Penalized Cox regression was used to predict 10-year all-cause mortality. The MDCI predicted risk of death better than the Charlson comorbidity index, with a c-index of 0.756 (95% confidence interval [CI] = 0.751, 0.762) vs 0.688 (95% CI = 0.683, 0.693) in the validation cohort of men without prostate cancer. Men in the lowest vs highest MDCI quartile had distinctively different survival in the validation cohort of men with prostate cancer, with an overall hazard ratio [HR] of 5.08 (95% CI = 4.90, 5.26). This was also consistent within strata of age and Charlson comorbidity index, e.g. HR = 5.90 (95% CI = 4.65, 7.50) in men younger than 60 years with CCI 0. These results indicate that comorbidity assessment in register-based studies can be improved by use of all ICD-10 codes and taking related frequency, recency, and duration of hospital admissions into account.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1371/journal.pone.0296804
الإتاحة: https://doi.org/10.1371/journal.pone.0296804Test
حقوق: http://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.2ED51E23
قاعدة البيانات: BASE