Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Usefulness of Comorbidity Indices in Operative Gastric Cancer Cases

위암 수술 환자의 건강결과 측정을 위한 동반상병 측정도구의 유용성 연구

  • Hwang, Se-Min (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Yoon, Seok-Jun (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Ahn, Hyeong-Sik (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • An, Hyong-Gin (Department of Biostatics, College of Medicine, Korea University) ;
  • Kim, Sang-Hoo (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Kyeong, Min-Ho (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Lee, Eun-Kyoung (Health Policy and Hospital Management Graduate School of Public Health, Korea University)
  • 황세민 (고려대학교 의과대학 예방의학교실) ;
  • 윤석준 (고려대학교 의과대학 예방의학교실) ;
  • 안형식 (고려대학교 의과대학 예방의학교실) ;
  • 안형진 (고려대학교 의과대학 의학통계학교실) ;
  • 김상후 (고려대학교 의과대학 예방의학교실) ;
  • 경민호 (고려대학교 의과대학 예방의학교실) ;
  • 이은경 (고려대학교 보건대학원 보건정책 및 병원관리학과)
  • Published : 2009.01.31
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Abstract

Objectives : The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index(CCI), Cumulative Illness rating scale(CIRS), Index of Co-existent Disease(ICED), and Kaplan-Feinstein Scale(KFS). Methods : The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. Results : The test-retest reliability of CCI and CIRS was substantial(Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate(Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate(Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair(Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay(p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). Conclusions : This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.

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