위암 수술 환자의 건강결과 측정을 위한 동반상병 측정도구의 유용성 연구

황세민; 윤석준; 안형진; 안형식; 김상후; 경민호; 이은경

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자료유형: 학술저널

저자정보: 황세민 윤석준 안형진 안형식 김상후 경민호 이은경

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제42권 제1호

발행연도: 2009.1

수록면: 49 - 58 (10page)

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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.

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.

#Gastric cancer #Comorbidity #Comorbidity index

참고문헌 (25)

참고문헌 신청

Ahn HS / 2006 / Association between unplanned readmission rate and volume of breast cancer operation cases / Int J Clin Pract 60 (1) : 32 ~ 35

Charlson M / 2007 / Can disease management target patients most likely to generate high costs? The impact of comorbidity / J Gen Intern Med 22 (4) : 464 ~ 469

Charlson ME / 1987 / A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation / J Chronic Dis 40 (5) : 373 ~ 383

Corser W / 2008 / Concordance between comorbidity data from patient selfreport interviews and medical record documentation / BMC Health Serv Res 8 : 85 ~ 85

Extermann M / 1998 / Comorbidity and functional status are independent in older cancer patients / J Clin Oncol 16 (4) : 1582 ~ 1587

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