Spss Code Elixhauser Comorbid Index Code With The
The Elixhauser comorbidity index is a well-validated aggregate of 30 comorbid conditions used to predict in-hospital mortality 13, 14. &0183 &32 and comorbidities listed in the Elixhauser comorbidity index. It incorporates thirty comorbid conditions and has been validated in acute-care inpatient hospital settings using administrative data. Methods:The Elixhauser Comorbidity Index Score (ECIS) is another popular comorbidity assessment method introduced by Elixhauser et al. MCHP Elixhauser Comorbidity Index SAS Code for the Medical Services / Physician Claims Data (3- and 5-Digit ICD-9-CM Codes) To run the MCHP Elixhauser Comorbidity Index SAS code with the Medical Services / Physician Claims data, a file containing individual physician visit records with the diagnosis codes is required.Skeletal muscle depletion (sarcopenia) predicts morbidity and mortality in the elderly and cancer patients.
Results:Overall, 38.9% were sarcopenic 16.7% had an infection and 9.0% had inpatient rehabilitation care. Administrative hospitalisation data encompassing the index surgical admission, direct transfers for inpatient rehabilitation care and hospital re-admissions within 30 days was searched for International Classification of Disease (ICD)-10 codes for postoperative infections and inpatient rehabilitation care and used to calculate length of stay (LOS). Sarcopenia was assessed using preoperative computed tomography images. Figure 2.4 Distribution of the Charlson Comorbidity Index of patients per.We tested whether sarcopenia predicts primary colorectal cancer resection outcomes in stage II–IV patients ( n=234). Statistical analysisHospital mortality is considered one of the key measures to assess and com-.
Conclusion:Sarcopenia predicts postoperative infections, inpatient rehabilitation care and consequently a longer LOS.Sarcopenia, frequently defined as an absolute muscle mass <2 s.d. In a multivariate model in patients ⩾65 years, sarcopenia was an independent predictor of both infection (odds ratio (OR) 4.6, (95% confidence interval (CI) 1.5, 13.9) P<0.01) and rehabilitation care (OR 3.1 (95% CI 1.04, 9.4) P<0.04). Inpatient rehabilitation was more common in sarcopenic patients overall (14.3% vs 5.6% P=0.024) and those ⩾65 years (24.1% vs 10.7%, P=0.06). Most (90%) inpatient rehabilitation care was in patients ⩾65 years. Infection risk was greater for sarcopenic patients overall (23.7% vs 12.5% P=0.025), and especially those ⩾65 years (29.6% vs 8.8%, P=0.005).
This led us to speculate that sarcopenic individuals may have difficulty in the context of a major surgical intervention. Recently, it has been revealed that sarcopenia in cancer patients is associated with treatment toxicity, poor functional status and decreased survival ( Prado et al, 2008, 2009, 2011 Antoun et al, 2010 van Vledder et al, 2012).The numerous poor outcomes associated with sarcopenia (survival, infection, length of hospital stay, treatment toxicity, physical disability) suggest that a sarcopenic individual is generally unfit or poorly equipped to deal with stress or disease. Computed tomography (CT) imaging, as routinely conducted in oncology, provides a means to precisely quantify skeletal muscle ( Mourtzakis et al, 2008 MacDonald et al, 2011 Baracos et al, 2012). Sarcopenia associates with poor physical function and nosocomial infections in non-cancer populations ( Pichard et al, 2004 Cosquéric et al, 2006).
Registry records were linked with hospital discharge abstracts including information on diagnoses, procedures and outcomes using ICD-10 codes. Patients were identified by a search of the Alberta Cancer Registry, which codes primary cancers in the province of Alberta by site, morphology, clinical and demographic information. The patient population ( n=234) was a consecutive cohort of Edmonton, Alberta, Canada residents with stage II–IV colorectal cancer (ICD-O codes: C18-C20 excluding appendix cancer (C18.1)) who underwent a colorectal procedure (segmental or partial colectomy, hemicolectomy, subtotal or total colectomy, sigmoid colon resection, anterior resection or abdominoperineal resection) between Apand March 31 2006. Our candidate population for this study was colorectal cancer patients undergoing primary tumour resection. The aim of this study was to test for an association between sarcopenia and these outcomes, by means of a review of Administrative Health Data (hospital discharge abstracts including information recorded using International Classification of Disease (ICD) 10 codes).Ethical approval was obtained from the Alberta Cancer Research Ethics Board.
Briefly, total skeletal muscle and adipose tissue surface area (cm 2) were evaluated on a single image at the third lumbar vertebrae (L3) using Hounsfield unit thresholds of −29 to +150 for skeletal muscle, −150 to −50 for visceral adipose tissue and −190 to −30 for subcutaneous and intermuscular adipose tissues. Computed tomography image analysis (Slice-O-Matic V4.3 software (Tomovision, Montreal, Canada)), was performed as described previously ( Mourtzakis et al, 2008). Images were retrieved from digital storage in the Picture Archiving and Communication System. Computed tomography image analysisComputed tomography scans taken for planning surgery were chosen they were taken on average 31 days prior to surgery. Height and weight were abstracted from records of routine clinical nutritional screening collected during consultations with the oncologist and were used to calculate the common anthropometric descriptor, body mass index (BMI).
Patients were considered to have presented with obstruction if the code K56.6 (other and unspecified intestinal obstruction) was reported in the index surgical hospital admission patients were considered to have presented with perforation if the code K63.1 (perforation of intestine (non traumatic)) was present in the index surgical admission.Data on infections and rehabilitation care following surgery were also identified from ICD-10 diagnostic codes from the inpatient hospitalisation administrative data as described above. Binary variables indicating the presence or absence of each comorbidity were created with the exception for obesity and weight loss, which are not properly captured using administrative health data.Obstruction and perforation were also identified using ICD-10 codes. The index surgery hospital admission, direct transfers to other facilities following the index surgical admission and re-admissions to hospital within 30 days of discharge from the index surgical admission and any hospitalisations in the year prior to the surgical hospitalisation were searched for comorbidities. Comorbidities were identified using a validated Elixhauser coding algorithm available for ICD-10 codes ( Quan et al, 2005 Lieffers et al, 2011). This data set includes all inpatient hospitalisations that occurred in any Alberta hospital and includes up to 16 ICD-10 diagnostic codes for each hospitalisation. Administrative dataComorbidities were obtained from inpatient hospitalisation administrative data provided by the provincial Ministry of Health.
Univariate and multivariate logistic regression were used to assess the relationship between sarcopenia and categorical variables. Two sample independent t-tests and χ 2/Fisher Exact tests were used to test for differences in continuous and categorical variables, respectively. Data are presented as mean±s.d. Statistical analysisSPSS v18.0 (IBM SPSS Statistics, Ontario, Canada) was used for statistical analysis. Decisions regarding discharge in this population reside with the individual surgeon.
Cancer stage, and tumour site were not associated with sarcopenia. Moreover, obstruction was more common in patients with sarcopenia and they were thus more likely to present for surgery on an emergency/urgent basis. Several comorbidities were more common in individuals with sarcopenia compared with those without including cardiac arrythmias, diabetes, hypertension, deficiency anaemia, hypothyroidism and fluid and electrolyte disorders. Individuals with sarcopenia were on average older, and had a lower BMI than those without sarcopenia men and women were equally likely to present with sarcopenia.
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