Multimorbidity is common among those living with diabetes. The purpose of this manuscript was to assess the performance of the recently developed M3 multimorbidity index within a large, well-defined cohort of patients with diabetes.
We compared regression model performance between three morbidity indices (M3, Charlson, Elixhauser) for important adverse outcomes (hospitalisation, amputation, and mortality) among 217,207 patients with diabetes, and compared the real-world applied impact of these indices for modelling these diabetes outcomes against two key exposure variables (ethnicity and deprivation).
The M3 Index out-performed both Charlson and Elixhauser Indices in terms of the prediction of hospitalisation events, amputation events, and death. When applied to models that were investigating the relationship between a) ethnicity and b) deprivation on risk of these outcomes, the M3 Index also explained more confounding due to multimorbidity than either Charlson or Elixhauser (e.g. shift in odds ratio toward the null when predicting hospitalisation: M3 Index 60%, Charlson 40%, Elixhauser 24%).
These results give additional support for the utility of the M3 index in clinical populations, adding to previous observations regarding its performance in a general population setting.
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 21 June 2023.
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