New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality
Abstract
Background and objective The ICD-9-CM adaptation of the Charlson comorbidity score has been a valuable resource for health services researchers. With the transition into ICD-10 coding worldwide, an ICD-10 version of the Deyo adaptation was developed and validated using population-based hospital data from Victoria, Australia. Methods The algorithm was translated from ICD-9-CM into ICD-10-AM (Australian modification) in a multistep process. After a mapping algorithm was used to develop an initial translation, these codes were manually examined by the coding experts and a general physician for face validity. Because the ICD-10 system is country specific, our goal was to keep many of the translated code at the three-digit level for generalizability of the new index. Results There appears to be little difference in the distribution of the Charlson Index score between the two versions. A strong association between increasing index scores and mortality exists: the area under the ROC curve is 0.865 for the last year using the ICD-9-CM version and remains high, at 0.855, for the ICD-10 version. Conclusion This work represents the first rigorous adaptation of the Charlson comorbidity index for use with ICD-10 data. In comparison with a well-established ICD-9-CM coding algorithm, it yields closely similar prevalence and prognosis information by comorbidity category.
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- Authors
- Sundararajan, V., Henderson, T., Perry, C., Muggivan, A., Quan, H., & Ghali, W. A.
- Affiliations
- Government of Victoria (AU)
- University of Calgary (CA)
- Corresponding author
- Sundararajan, Vijaya
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2004-12
- Volume
- 57
- Issue
- 12
- Pages
- 1288-1294
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W2165037395
- Cited by
- 2,439
- References
- 3
- Citations by year
- 2026: 107 · 2025: 194 · 2024: 220 · 2023: 255 · 2022: 260 · 2021: 274 · 2020: 198 · 2019: 129 · 2018: 99 · 2017: 116 · 2016: 96 · 2015: 64 · 2014: 88 · 2013: 62 · 2012: 57
- FWCI
- 25.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- Charlson Comorbidity Index, ICD-10, ICD-9-CM, comorbidity measurement, in-hospital mortality, mortality prediction, hospital data
- MeSH terms
- Algorithms, Humans, Middle Aged, ROC Curve, Victoria, Comorbidity, Hospital Mortality, International Classification of Diseases
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