A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.

<h4>Background</h4>The Charlson Comorbidity Index is a poor predictor of mortality in men with castration resistant prostate cancer (CRPC). To improve this prediction, we created a comorbidity index based on filled prescriptions intended to be used in registry-based studies.<h4>Mat...

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Autores principales:	Giuseppe Fallara, Rolf Gedeborg, Anna Bill-Axelson, Hans Garmo, Pär Stattin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2a6d8ad71fb2473aadf774cc8d7856c0
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spelling	oai:doaj.org-article:2a6d8ad71fb2473aadf774cc8d7856c02021-12-02T20:09:01ZA drug comorbidity index to predict mortality in men with castration resistant prostate cancer.1932-620310.1371/journal.pone.0255239https://doaj.org/article/2a6d8ad71fb2473aadf774cc8d7856c02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255239https://doaj.org/toc/1932-6203<h4>Background</h4>The Charlson Comorbidity Index is a poor predictor of mortality in men with castration resistant prostate cancer (CRPC). To improve this prediction, we created a comorbidity index based on filled prescriptions intended to be used in registry-based studies.<h4>Materials and methods</h4>In a population-based cohort of men with CPRC a drug comorbidity index (DCI-CRPC) was calculated based on prescriptions filled during a 365-day period before the date of CRPC diagnosis to predict mortality. Five risk categories for men with CRPC were defined based on PSA kinetics. Mortality rates were described by Kaplan-Meier curves. The predictive ability of the DCI-CRPC was compared in univariable models to that of the original DCI, derived from men in the general population, and to that of the Charlson Comorbidity Index.<h4>Results</h4>In 1,885 men with CRPC the median overall survival ranged from 3.0 years (95% confidence interval [CI] 2.8 to 3.4) in the first tertile of the DCI-CRPC, to 1.0 year (95% CI 0.9 to 1.1) in the third tertile of the DCI-CRPC. The index had higher discriminative ability (C-index 0.667) than the Charlson Comorbidity Index (C-index 0.508). The discriminative ability of the DCI-CRPC was highest in the subgroup with least aggressive cancer (C-index 0.651) and lowest in men with most aggressive cancer (C-index 0.618). The performance of the DCI-CRPC was comparable to that of the original DCI.<h4>Conclusion</h4>Our newly created comorbidity index using filled prescriptions predicted death in men with CRPC better than the Charlson Comorbidity Index.Giuseppe FallaraRolf GedeborgAnna Bill-AxelsonHans GarmoPär StattinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255239 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Giuseppe Fallara Rolf Gedeborg Anna Bill-Axelson Hans Garmo Pär Stattin A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
description	<h4>Background</h4>The Charlson Comorbidity Index is a poor predictor of mortality in men with castration resistant prostate cancer (CRPC). To improve this prediction, we created a comorbidity index based on filled prescriptions intended to be used in registry-based studies.<h4>Materials and methods</h4>In a population-based cohort of men with CPRC a drug comorbidity index (DCI-CRPC) was calculated based on prescriptions filled during a 365-day period before the date of CRPC diagnosis to predict mortality. Five risk categories for men with CRPC were defined based on PSA kinetics. Mortality rates were described by Kaplan-Meier curves. The predictive ability of the DCI-CRPC was compared in univariable models to that of the original DCI, derived from men in the general population, and to that of the Charlson Comorbidity Index.<h4>Results</h4>In 1,885 men with CRPC the median overall survival ranged from 3.0 years (95% confidence interval [CI] 2.8 to 3.4) in the first tertile of the DCI-CRPC, to 1.0 year (95% CI 0.9 to 1.1) in the third tertile of the DCI-CRPC. The index had higher discriminative ability (C-index 0.667) than the Charlson Comorbidity Index (C-index 0.508). The discriminative ability of the DCI-CRPC was highest in the subgroup with least aggressive cancer (C-index 0.651) and lowest in men with most aggressive cancer (C-index 0.618). The performance of the DCI-CRPC was comparable to that of the original DCI.<h4>Conclusion</h4>Our newly created comorbidity index using filled prescriptions predicted death in men with CRPC better than the Charlson Comorbidity Index.
format	article
author	Giuseppe Fallara Rolf Gedeborg Anna Bill-Axelson Hans Garmo Pär Stattin
author_facet	Giuseppe Fallara Rolf Gedeborg Anna Bill-Axelson Hans Garmo Pär Stattin
author_sort	Giuseppe Fallara
title	A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
title_short	A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
title_full	A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
title_fullStr	A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
title_full_unstemmed	A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
title_sort	drug comorbidity index to predict mortality in men with castration resistant prostate cancer.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2a6d8ad71fb2473aadf774cc8d7856c0
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A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.

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