MDS-Comorbidity Index using register data has prognostic impact in Swedish MDS patients

• Published in: Leukemia research Vol. 134; p. 107386
• Main Authors: Larfors, Gunnar, Moreno Berggren, Daniel, Garelius, Hege, Nilsson, Lars, Rasmussen, Bengt, Hellström-Lindberg, Eva, Ejerblad, Elisabeth
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2023
• Subjects: Cohort studies; Comorbidity; Epidemiology; Humans; Medicin och hälsovetenskap; Myelodysplastic syndromes; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - epidemiology; Prognosis; Retrospective Studies; Risk Factors; Sweden - epidemiology; Sweden; Prognosis; Comorbidity; Epidemiology; Myelodysplastic syndromes; Cohort studies
• ISSN: 0145-2126; 1873-5835; 1873-5835
• DOI: 10.1016/j.leukres.2023.107386

Comorbidities influence the mortality in patients with myelodysplastic syndromes, and a growing body of evidence suggest that comorbidity history should be used in addition to established prognostic indices. A comorbidity index specific for MDS, the MDS-CI, was introduced a decade ago. In this study we aim to construct an MDS-CI version based on diagnoses from register data only, to expand its use beyond the clinical setting to retrospective and register based studies. We further test this version on a Swedish population-based MDS cohort of 2947 patients, and compare its prognostic accuracy to that of Charlson Comorbidity Index. Our register based MDS-CI divided patients into three risk groups of similar proportions as have been published for the original MDS-CI. Compared to low risk patients, intermediate and high risk patients had 50 % and 70 % higher mortality, respectively. The prognostic value of MDS-CI was equal to that of Charlson comorbidity index. Adding MDS-CI to the established prognostic factors IPSS-R and age increased the prognostic accuracy. In summary, we demonstrate that MDS-CI can be adequately estimated from diagnoses recorded in registers only, and that it is a useful tool in any future study on myelodysplastic syndromes with a need to adjust for comorbidities. •We present a modified MDS-Comorbidity Index derived from registered diagnoses only.•At MDS diagnosis, 41 % of patients had a comorbidity index of one or more.•Our register based index predicted mortality equally as Charlson comorbidity index.•Adding register based MDS-CI to IPSS-R increased the prognostic accuracy.