A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink
Purpose: The CirCom score has been developed from Danish data as a specific measure of comorbidity for cirrhosis to predict all-cause mortality. We compared its performance with the Charlson Comorbidity Index (CCI) in an English cirrhosis population. Patients and methods: We used comorbidity scores...
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| Format: | Article |
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Dove Press
2018
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| Online Access: | https://eprints.nottingham.ac.uk/49109/ |
| _version_ | 1848797923869982720 |
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| author | Crooks, Colin J. West, Joe Jepson, Peter |
| author_facet | Crooks, Colin J. West, Joe Jepson, Peter |
| author_sort | Crooks, Colin J. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose: The CirCom score has been developed from Danish data as a specific measure of comorbidity for cirrhosis to predict all-cause mortality. We compared its performance with the Charlson Comorbidity Index (CCI) in an English cirrhosis population.
Patients and methods: We used comorbidity scores in a survival model to predict mortality in a cirrhosis cohort in the Clinical Practice Research Datalink. The discrimination of each score was compared by age, gender, socioeconomic status, cirrhosis etiology, cirrhosis stage, and year after cirrhosis diagnosis. We also measured their ability to predict liver-related versus non-liver-related death.
Results: There was a small improvement in the C statistic from the model using the CirCom score (C=0.63) compared to the CCI (C=0.62), and there was an overall improvement in the net reclassification index of 1.5%. The improvement was more notable in younger patients, those with an alcohol etiology, and those with compensated cirrhosis. Both scores performed better (C statistic >0.7) for non-liver-related deaths than liver-related deaths (C statistic <0.6), as comorbidity was only weakly predictive of liver-related death.
Conclusion: The CirCom score provided a small improvement in performance over the CCI in the prediction of all-cause and non-liver mortality, but not liver-related mortality. Therefore, it is important to include a measure of comorbidity in studies of cirrhosis survival, alongside a measure of cirrhosis severity. |
| first_indexed | 2025-11-14T20:11:36Z |
| format | Article |
| id | nottingham-49109 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:11:36Z |
| publishDate | 2018 |
| publisher | Dove Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-491092024-08-15T15:26:04Z https://eprints.nottingham.ac.uk/49109/ A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink Crooks, Colin J. West, Joe Jepson, Peter Purpose: The CirCom score has been developed from Danish data as a specific measure of comorbidity for cirrhosis to predict all-cause mortality. We compared its performance with the Charlson Comorbidity Index (CCI) in an English cirrhosis population. Patients and methods: We used comorbidity scores in a survival model to predict mortality in a cirrhosis cohort in the Clinical Practice Research Datalink. The discrimination of each score was compared by age, gender, socioeconomic status, cirrhosis etiology, cirrhosis stage, and year after cirrhosis diagnosis. We also measured their ability to predict liver-related versus non-liver-related death. Results: There was a small improvement in the C statistic from the model using the CirCom score (C=0.63) compared to the CCI (C=0.62), and there was an overall improvement in the net reclassification index of 1.5%. The improvement was more notable in younger patients, those with an alcohol etiology, and those with compensated cirrhosis. Both scores performed better (C statistic >0.7) for non-liver-related deaths than liver-related deaths (C statistic <0.6), as comorbidity was only weakly predictive of liver-related death. Conclusion: The CirCom score provided a small improvement in performance over the CCI in the prediction of all-cause and non-liver mortality, but not liver-related mortality. Therefore, it is important to include a measure of comorbidity in studies of cirrhosis survival, alongside a measure of cirrhosis severity. Dove Press 2018-01-15 Article PeerReviewed Crooks, Colin J., West, Joe and Jepson, Peter (2018) A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink. Clinical Epidemiology, 2018:10 . pp. 107-120. ISSN 1179-1349 cirrhosis mortality comorbidity prognosis cause of death cohort https://www.dovepress.com/a-validation-study-of-the-circom-comorbidity-score-in-an-english-cirrh-peer-reviewed-article-CLEP doi:10.2147/CLEP.S147535 doi:10.2147/CLEP.S147535 |
| spellingShingle | cirrhosis mortality comorbidity prognosis cause of death cohort Crooks, Colin J. West, Joe Jepson, Peter A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title | A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title_full | A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title_fullStr | A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title_full_unstemmed | A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title_short | A validation study of the CirCom comorbidity score in an English cirrhosis population using the Clinical Practice Research Datalink |
| title_sort | validation study of the circom comorbidity score in an english cirrhosis population using the clinical practice research datalink |
| topic | cirrhosis mortality comorbidity prognosis cause of death cohort |
| url | https://eprints.nottingham.ac.uk/49109/ https://eprints.nottingham.ac.uk/49109/ https://eprints.nottingham.ac.uk/49109/ |