OBJECTIVES

: We aimed to develop a cardiovascular patient-specific comorbidity index for predicting mortality in Korean adults.

METHODS

: In the NHIS-NSC, we used 70% of myocardial infarction or stroke patients admitted firstly between January 1, 2004 and December 31, 2012 and ≥25 aged to develop CVD-CI (cardiovascular disease comorbidity index) for predicting 3-year mortality. We selected comorbidities among the CCI and ECI of conditions significant related with our subjects and scoring by using multiple Cox hazard regression model. In the 30% of cohort, we validated our index by comparing the performance with CCI and ECI using the Roc curve.

RESULTS

Of the 18,554 patients, 12,988 and 5,566 were assigned in development cohort and validation cohort, respectively. A total of 18 new comorbidities were selected and the weight ranged from -1 to 9. The most strongly associated comorbidities on mortality were metastatic cancer, severe liver disease, kidney disease, drug abuse, and pulmonary circular disease. C-statistics of CVD-CI was 0.775 [95% confidence interval (CI): 0.761-0.790], CCI was 0.766 (95% CI: 0.751-0.781), and ECI was 0.767(95% CI: 0.752-0.782) after adjusted for age, sex, degree of disability, surgical status, hospitalization history, and type of healthcare system.

CONCLUSIONS

: CVD-CI performed better than traditional indices like CCI and ECI for predicting mortality of patients with stroke or myocardial infarction and could be useful method in adjusting comorbidities.