In
medicine
Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
, the Elixhauser Comorbidity Index is a measure of overall severity of
comorbidities
In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sickness" ...
, predicting hospital length of stay, hospital charges, and in-hospital mortality.
The higher the score, the higher the predicted hospital resource use and mortality rate are. For a physician, this score is helpful in deciding how aggressively to treat a condition.
Conditions can be identified using the
International Classification of Diseases (ICD) diagnosis codes commonly used in patient records.
The measurement was developed by
Anne Elixhauser and colleagues in 1998 and initially included 30 diseases with a uniform weighting for each. The methodology has been adapted several times since then, with the introduction of weights in 2009
and adjustments to the list of categories considered.
Comparison with other comorbidity measures
The measure is most similar to the
Charlson Comorbidity Index (CCI), which considers a smaller set of diseases and applies different weights.
While CCI is one of the most widely used scoring system for comorbidities,
a
systematic review
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on ...
and comparative analysis shows that among various comorbidities indices, Elixhauser index is a better predictor of the risk especially beyond 30 days of hospitalization.
History
The Elixhauser comorbidity measure was originally published in 1998 in ''Medical Care''
and developed using administrative data from a statewide California inpatient database from all non-federal inpatient community hospital stays in California (''n'' = 1,779,167). The Elixhauser comorbidity measure developed a list of 30 comorbidities relying on the ICD-9-CM coding manual. The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital changes, and mortality) differently among different patients groups. The comorbidities identified by the Elixhauser comorbidity measure are significantly associated with in-hospital mortality and include both acute and chronic conditions.
In 2009, van Walraven et al. have derived and validated an Elixhauser comorbidity index that summarizes
disease burden
Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Both ...
and can discriminate for in-hospital mortality.
See also
*
Comorbidity
In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sicknes ...
*
Charlson Comorbidity Index (CCI)
*
Comorbidity–polypharmacy score (CPS)
References
{{Reflist, 30em
Comorbidity measures