Article

Burn patients exhibit comorbidities that influence outcomes. This
study examines whether existing comorbidity measures capture comorbidities in the
burn inpatient rehabilitation population. DESIGN: Data were obtained from the
Uniform Data System for Medical Rehabilitation from 2002 to 2011 for adults with
burn injury. International Classification of Diseases, 9th Revision, codes were
used to assess three comorbidity measures (Charlson Comorbidity Index, Elixhauser
Comorbidity Index, Centers for Medicare and Medicaid Services Comorbidity Tiers).
The number of subjects and unique comorbidity codes (>1% of frequency) captured
by each comorbidity measure was calculated. RESULTS: The study included 5347
patients with a median total body surface area burn decile of 20%-29%, mean age
of 51.6 yrs, and mean number of comorbidities of 7.6. There were 2809 unique
International Classification of Diseases, 9th Revision, comorbidity codes. The
Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Centers for
Medicare and Medicaid Services Comorbidity Tiers did not capture 67%, 27%, and
58% of the subjects, respectively. There were 107 unique comorbidities that
occurred with a frequency of greater than 1%. Of these, 67% were not captured in
all three comorbidity measures. CONCLUSIONS: Commonly used comorbidity indexes do
not reflect the extent of comorbid disease in the burn rehabilitation population.
Future work is needed to assess the need for comorbidity indexes specific to the
inpatient rehabilitation setting.

Langue : ANGLAIS