Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis

Objectives: To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDC...

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Autores principales:	Yun-Ju Huang, Jung-Sheng Chen, Shue-Fen Luo, Chang-Fu Kuo
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	rheumatoid arthritis Charlson Comorbidity Index Elixhauser Comorbidity Index Multimorbidity Index Rheumatic Disease Comorbidity Index comorbidity Medicine R
Acceso en línea:	https://doaj.org/article/64306fba982b4570b298cf9ff06fb08c
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spelling	oai:doaj.org-article:64306fba982b4570b298cf9ff06fb08c2021-11-25T18:03:02ZComparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis10.3390/jcm102254602077-0383https://doaj.org/article/64306fba982b4570b298cf9ff06fb08c2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5460https://doaj.org/toc/2077-0383Objectives: To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDCI) scores and to investigate their predictive ability for all-cause mortality. Methods: We identified 24,767 RA patients diagnosed from 1998 to 2008 in Taiwan and followed up until 31 December 2013. The incidence of comorbidities was estimated in three periods (before, during, and after the diagnostic period). The incidence rate ratios were calculated by comparing during vs. before and after vs. before the diagnostic period. One- and 5-year mortality rates were calculated and discriminated by low and high-score groups and modified models for each index. Results: The mean score at diagnosis was 0.8 in CCI, 2.8 in ECI, 0.7 in MMI, and 1.3 in RDCI, and annual percentage changes are 11.0%, 11.3%, 9.7%, and 6.8%, respectively. The incidence of any increase in the comorbidity index was significantly higher in the periods of “during” and “after” the RA diagnosis (incidence rate ratios for different indexes: 1.33–2.77). The mortality rate significantly differed between the high and low-score groups measured by each index (adjusted hazard ratios: 2.5–4.3 for different indexes). CCI was slightly better in the prediction of 1- and 5-year mortality rates. Conclusions: Comorbidities are common before and after RA diagnosis, and the rate of accumulation accelerates after RA diagnosis. All four comorbidity indexes are useful to measure the temporal changes and to predict mortality.Yun-Ju HuangJung-Sheng ChenShue-Fen LuoChang-Fu KuoMDPI AGarticlerheumatoid arthritisCharlson Comorbidity IndexElixhauser Comorbidity IndexMultimorbidity IndexRheumatic Disease Comorbidity IndexcomorbidityMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5460, p 5460 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis Charlson Comorbidity Index Elixhauser Comorbidity Index Multimorbidity Index Rheumatic Disease Comorbidity Index comorbidity Medicine R
spellingShingle	rheumatoid arthritis Charlson Comorbidity Index Elixhauser Comorbidity Index Multimorbidity Index Rheumatic Disease Comorbidity Index comorbidity Medicine R Yun-Ju Huang Jung-Sheng Chen Shue-Fen Luo Chang-Fu Kuo Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
description	Objectives: To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDCI) scores and to investigate their predictive ability for all-cause mortality. Methods: We identified 24,767 RA patients diagnosed from 1998 to 2008 in Taiwan and followed up until 31 December 2013. The incidence of comorbidities was estimated in three periods (before, during, and after the diagnostic period). The incidence rate ratios were calculated by comparing during vs. before and after vs. before the diagnostic period. One- and 5-year mortality rates were calculated and discriminated by low and high-score groups and modified models for each index. Results: The mean score at diagnosis was 0.8 in CCI, 2.8 in ECI, 0.7 in MMI, and 1.3 in RDCI, and annual percentage changes are 11.0%, 11.3%, 9.7%, and 6.8%, respectively. The incidence of any increase in the comorbidity index was significantly higher in the periods of “during” and “after” the RA diagnosis (incidence rate ratios for different indexes: 1.33–2.77). The mortality rate significantly differed between the high and low-score groups measured by each index (adjusted hazard ratios: 2.5–4.3 for different indexes). CCI was slightly better in the prediction of 1- and 5-year mortality rates. Conclusions: Comorbidities are common before and after RA diagnosis, and the rate of accumulation accelerates after RA diagnosis. All four comorbidity indexes are useful to measure the temporal changes and to predict mortality.
format	article
author	Yun-Ju Huang Jung-Sheng Chen Shue-Fen Luo Chang-Fu Kuo
author_facet	Yun-Ju Huang Jung-Sheng Chen Shue-Fen Luo Chang-Fu Kuo
author_sort	Yun-Ju Huang
title	Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
title_short	Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
title_full	Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
title_fullStr	Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
title_full_unstemmed	Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
title_sort	comparison of indexes to measure comorbidity burden and predict all-cause mortality in rheumatoid arthritis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/64306fba982b4570b298cf9ff06fb08c
work_keys_str_mv	AT yunjuhuang comparisonofindexestomeasurecomorbidityburdenandpredictallcausemortalityinrheumatoidarthritis AT jungshengchen comparisonofindexestomeasurecomorbidityburdenandpredictallcausemortalityinrheumatoidarthritis AT shuefenluo comparisonofindexestomeasurecomorbidityburdenandpredictallcausemortalityinrheumatoidarthritis AT changfukuo comparisonofindexestomeasurecomorbidityburdenandpredictallcausemortalityinrheumatoidarthritis
_version_	1718411682830614528

Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis

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