Objective:

The Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) are commonly utilized measures that use administrative data to characterize a patient’s comorbidity burden. The purpose of this study was to compare the ability of these measures to predict outcomes following anterior lumbar interbody fusions (ALIF).

Methods:

he National Inpatient Sample (NIS) was queried for all ALIF procedures between 2013-2014. The area under the receiver operating curve (AUC) was used to compare the ECI and CCI in their ability to predict postoperative complications when incorporated into a base model containing age, sex, race, and primary payer. Percent superiority was computed using AUC values for ECI, CCI, and base models.

Results:

A total of 43,930 hospitalizations were included in this study. The ECI was superior to the CCI and baseline models in predicting minor (AUC 71 vs. 0.66, p<0.0001) and major (AUC 0.74 vs. 0.67, p<0.0001) complications. When evaluating individual complications, the ECI was superior to the CCI in predicting airway complications (65% superior, AUC 0.85 vs. 0.72, p=0.0001), hemorrhagic anemia (83% superior, AUC 0.71 vs. 0.66, p<0.0001), myocardial infarction (76% superior, AUC 0.86 vs. 0.67, p<0.0001), cardiac arrest (75% superior, AUC 0.85 vs. 0.67, p<0.0001), pulmonary embolism (105% superior, AUC 0.91 vs. 0.71, p<0.0001), and urinary tract infection (43% superior, AUC 0.76 vs. 0.73, p=0.046).

Conclusions:

The ECI was superior to the CCI in predicting 6 of the 15 complications analyzed in this study. Combined with previous results, the ECI may be a better predictive model in spine surgery.