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논문분류	춘계학술대회 초록집
제목	Recalibration and validation of the Charlson comorbidity index in Asian population: the National Health Insurance Service-National Sample Cohort study
저자	Jae shin CHOI1, Jae shin CHOI1, Myoung-hee KIM3, Yong chul KIM1, Jung nam AN2, Jae yoon PARK5, Dong ki KIM1, Ho KIM4, Yun kyu OH2, Yon su KIM1, Chun-soo LIM2, *Jung pyo LEE2
출판정보	2017; 2017(1):
키워드
초록	Objectives : Weights assigned to comorbidities to predict mortality may vary based on the type of index disease and advances in the management of comorbidities. We aimed to develop a modified Charlson comorbidity index (CCI) in an Asian nationwide database (mCCI-A), thereby predicting their mortality more precisely. Methods : The main data source used in this study was the National Health Insurance Service-National Sample Cohort (NHIS-NSC) constructed from the National Health Insurance database, which includes health insurance claims between January 1, 2002 and December 31, 2013 in Korea. Of the 1,025,340 individuals included in the NHIS-NSC, 578,547 patients who were hospitalized at least once were analyzed for this study. mCCI-A score were calculated by summing up the weights which were assigned to individual comorbidities according to their relative prognostic significance determined by multivariate Cox proportional hazard model. The modified index was validated in the same cohort. Results : The Cox proportional hazards model provided reassigned severity weights for 17 comorbidities that significantly predicted mortality. Both the CCI and the mCCI-A were correlated with mortality. However, the mCCI-A showed modest but significant increases in c statistics compared with the CCI. The analyses using continuous net reclassification improvement revealed that the mCCI-A improved net mortality risk reclassification by 23.1% (95% CI, 22.0- 24.3; P<0.001). Conclusions : The mCCI-A facilitates better risk stratification for mortality in Korean inpatients compared with the CCI, suggesting that it may be a preferred index for use in clinical practice and the statistical analysis of epidemiological studies.
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