To develop and validate an updated morbidity index for short-term mortality risk, using chronic conditions identified from routine hospital admission ICD-10 data.
Retrospective cohort study of all adult New Zealand (NZ) residents at 1st Jan 2012.
Adult NZ residents aged 18 and over, defined by enrolment with a Primary Healthcare Organisation or accessing public healthcare in preceding year. Data were split into two datasets for index development (70%, n=2,331,645) and validation (30%, n=1,000,166).
The M3 index was constructed using log hazard ratios for one-year mortality modelled from presence of 61 chronic conditions. Validation results were improved for the M3 index for predicting one-year mortality compared to Charlson and Elixhauser on the c-statistic (M3: 0.931, Charlson 0.921, Elixhauser 0.922; difference M3 vs Charlson = 0.010, 95% CI 0.008, 0.012; M3 vs Elixhauser = 0.009, 95% CI 0.007, 0.012) and integrated discriminative improvement (IDI: M3 vs Charlson=0.024, 95% CI 0.021, 0.026; M3 vs Elixhauser=0.024, 95% CI 0.022, 0.027).
The M3 index had improved predictive performance for one-year mortality risk over Charlson and Elixhauser indices, allowing better adjustment for mortality risk from chronic conditions. This provides an important tool for population-level analyses of health outcomes.
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 August 2017.
All research outputs
#16,167,138
of 27,470,210 outputs
Outputs from Journal of Clinical Epidemiology
#4,044
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Outputs of similar age
#166,991
of 331,645 outputs
Outputs of similar age from Journal of Clinical Epidemiology
#49
of 61 outputs
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