Table 1.
Summary of comorbidity indices used in orthopaedic surgery
| Comorbidity measure: | ASA Physical Status Classification | Charlson Comorbidity Index (CCI) | Age-Adjusted Charlson (ACCI) | Modified Charlson (mCCI)** | Elixhauser Comorbidity Measure (ECM) | Weighted Elixhauser | Modified Frailty Index (mFI) | 5-Factor modified Frailty (mFI-5) | RxRisk-V |
|---|---|---|---|---|---|---|---|---|---|
| Year of publication | 1941 | 1987 | 1994 | 2017 | 1998 | 2009 | 2013 | 2018 | 2003 |
| Author(s) | Saklad15 | Charlson et al11 | Charlson et al42 |
Lakomkin et al44 |
Elixhauser et al12 | van Walraven et al55 | Velanovich et al58 | Subramaniam et al61 | Sloan et al63 |
| Original study population | Decision by members of the ASA to classify a patient based solely on physical state. | 604 patients admitted to the internal medicine service at New York Hospital-Cornell Medical Center in 1984. | 218 patients who underwent elective general surgery between 1982 and 1985. | 6,121 revision hip arthroplasty patients between 2006 and 2013. | 1,779,167 patients admitted to an acute care hospital in 1992. | 228,565 adult hospitalizations at The Ottawa Hospital, Canada between 1996 and 2007. | 971,434 surgical inpatients across all surgical specialties between 2005 and 2009. | Clinical data for patients across surgical specialties contained within the NSQIP database in 2012. | 126,075 veteran users of VHA services (Northwest Network) in 1998. |
| Type of data | Clinical | Clinical | Clinical | ACS NSQIP Clinical data | Administrative | Administrative | ACS NSQIP Clinical data | ACS NSQIP Clinical data | Veteran Health Administrative Data |
| Predicted outcome(s) in arthroplasty | 3-month revision/reoperation, 6-month mortality, 6-month Oxford Scores, 2-year revision, length of stay, health-related quality of life, any adverse event | Hospital readmission, length of stay, EQ visual analogue scale | 5-year mortality | Mortality, major and minor complications, length of stay, blood transfusion, and any adverse event | Length of stay, postoperative complications, discharge disposition, and EQ-5D index | 90-day readmission | 30-day morbidity, mortality, readmission, and reoperation | 30-day mortality, postoperative complications, readmission, and surgical site infection | 90-day and 1-year mortality, 1-year and 5-year revision, and infection |
| Number of variables | N/A | 19 | 19 | 10 | 30 | 21 | 11 | 5 | 45 |
| Single summary score? | No | Yes | Yes | Yes | No | Yes | Yes | Yes | No |
Notes. ACS NSQIP, American College of Surgeons National Surgical Quality Improvement Program; ASA, American Society of Anesthesiologists; EQ, European Quality of Life; EQ-5D, European Quality of Life Five Dimensions; VHA, Veterans Health Administration.
**
Reflects information for the mCCI used in orthopaedics by Lakomkin et al.44