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20 Based on Quan's protocol, each ICD-10 code of comorbidity was converted into a score, and was summed for each patient to determine CCI.
Based on Quan's protocol [ 22], each ICD-10 code of comorbidity was converted into a score, and was summed up for each patient to calculate a Charlson Comorbidity Index (CCI).
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The overall burden of comorbidity was measured by the Charlson Index (CI) using the ICD-10 comorbidity coding algorithm from Quan et al. [ 24].
A full list of ICD-10-GM codes included for the assessment of comorbidity is available on request.
Furthermore, different coding practices across hospitals and misclassification of comorbidity are unlikely to be associated with hospital payment type.
Independent predictors of comorbidity were identified through logistic regression.
The variable, number of comorbidities was recoded into a binary variable, < 3 comorbidities or ≥ 3 comorbidities.
To ensure mutual exclusivity of the comorbidities and outcomes, the renal failure unspecified (ICD-9 code 586) comorbidity was removed because it overlapped with the administrative outcome.
To quantify the extent of comorbidities, the ICD-10 code for each comorbidity was converted to a score, and the sum was used to calculate the Charlson comorbidity index (CCI) as previously described [ 22, 27, 28].
To quantify the extent of the comorbidities, the ICD-10 code for each comorbidity was converted to a score, and the sum was used to calculate the Charlson Comorbidity Index (CCI), as described previously [15, 21, 22].
Age, previous hospital admission and number of comorbidities were associated with under-reporting of comorbidities in the administrative database., Although there is no limit to the number of secondary diagnoses that can be coded, having a higher number of concurrent comorbidities may result in less important comorbidities being disregarded.
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