A Comparison of the Charlson and Elixhauser Methods for Predicting Nursing Indicators in Gastrectomy with Gastric Cancer Patients

Comorbidity indices such as Charlson's (CCI) and Elixhauser's (ECI) are used to adjust the patient's care, depending on the severity of their condition. However, no study has compared these indices' ability to predict nursing-sensitive outcomes (NSOs). We compared the performance...

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Bibliographic Details
Published inHealthcare (Basel) Vol. 11; no. 13; p. 1830
Main Authors Kim, Chul-Gyu, Bae, Kyun-Seop
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 22.06.2023
MDPI
Subjects
Cancer surgery
Care and treatment
Comorbidity
Comparative analysis
Complications
Complications and side effects
Emergency medical care
Gastrectomy
Gastric cancer
Health risks
Medical protocols
Methods
Mortality
Nursing care
Oncologic nursing
patient outcome assessment
risk adjustment
Stomach cancer
Surgery
South Korea
risk adjustment
nursing care
patient outcome assessment
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Summary:Comorbidity indices such as Charlson's (CCI) and Elixhauser's (ECI) are used to adjust the patient's care, depending on the severity of their condition. However, no study has compared these indices' ability to predict nursing-sensitive outcomes (NSOs). We compared the performance of CCI and ECI in predicting NSOs in gastric cancer patients' gastrectomy. Gastric cancer patients with gastrectomy, aged 19 years or older and admitted between 2015 and 2016, were selected from the Korea Insurance Review and Assessment Service database. We examined the relationships between NSOs and CCI or ECI while adjusting patient and hospital characteristics with logistic regression. The ECI item model was the best in view of the C-statistic and Akaike Information Criterion for total NSO, physiologic/metabolic derangement, and deep vein thrombosis, while the Charlson item model was the best for upper gastrointestinal tract bleeding. For the C-statistic, the ECI item model was the best for in-hospital mortality, CNS complications, shock/cardiac arrest, urinary tract infection, pulmonary failure, and wound infection, while the CCI item model was the best for hospital-acquired pneumonia and pressure ulcers. In predicting 8 of 11 NSOs, the ECI item model outperformed the others. For other NSOs, the best model varies between the ECI item and CCI item model.
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ISSN:2227-9032
2227-9032
DOI:10.3390/healthcare11131830