{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:26:09Z","timestamp":1767857169875,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Objective: Comorbidity adjustment is often performed during outcomes and health care resource utilization research. Our goal was to develop an efficient algorithm in structured query language (SQL) to determine the Elixhauser comorbidity index.<\/jats:p>\n               <jats:p>Materials and Methods: We wrote an SQL algorithm to calculate the Elixhauser comorbidities from Diagnosis Related Group and International Classification of Diseases (ICD) codes. Validation was by comparison to expected comorbidities from combinations of these codes and to the 2013 Nationwide Readmissions Database (NRD).<\/jats:p>\n               <jats:p>Results: The SQL algorithm matched perfectly with expected comorbidities for all combinations of ICD-9 or ICD-10, and Diagnosis Related Groups. Of 13\u2009585\u2009859 evaluable NRD records, the algorithm matched 100% of the listed comorbidities. Processing time was \u223c0.05\u2009ms\/record.<\/jats:p>\n               <jats:p>Discussion: The SQL Elixhauser code was efficient and computationally identical to the SAS algorithm used for the NRD.<\/jats:p>\n               <jats:p>Conclusions: This algorithm may be useful where preprocessing of large datasets in a relational database environment and comorbidity determination is desired before statistical analysis. A validated SQL procedure to calculate Elixhauser comorbidities and the van Walraven index from ICD-9 or ICD-10 discharge diagnosis codes has been published.<\/jats:p>","DOI":"10.1093\/jamia\/ocw181","type":"journal-article","created":{"date-parts":[[2017,1,3]],"date-time":"2017-01-03T20:05:50Z","timestamp":1483473950000},"page":"845-850","source":"Crossref","is-referenced-by-count":25,"title":["Development and validation of a structured query language implementation of the Elixhauser comorbidity index"],"prefix":"10.1093","volume":"24","author":[{"given":"Richard H","family":"Epstein","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, FL, USA"}]},{"given":"Franklin","family":"Dexter","sequence":"additional","affiliation":[{"name":"Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, IA, USA"}]}],"member":"286","published-online":{"date-parts":[[2017,2,16]]},"reference":[{"key":"2020110612442952600_ocw181-B1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med Care."},{"key":"2020110612442952600_ocw181-B2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1472-6963-8-12","article-title":"Risk adjustment performance of Charlson and Elixhauser comorbidities in ICD-9 and ICD-10 administrative databases","volume":"8","author":"Li","year":"2008","journal-title":"BMC Health Services Res."},{"key":"2020110612442952600_ocw181-B3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/01.mlr.0000118861.56848.ee","article-title":"Comparison of the Elixhauser and Charlson\/Deyo methods of comorbidity measurement in administrative data","volume":"42","author":"Southern","year":"2004","journal-title":"Med Care."},{"key":"2020110612442952600_ocw181-B4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/01.sla.0000250422.36168.67","article-title":"The effects of preexisting medical comorbidities on mortality and length of hospital stay in acute burn injury: evidence from a national sample of 31,338 adult patients","volume":"245","author":"Thombs","year":"2007","journal-title":"Ann Surg."},{"key":"2020110612442952600_ocw181-B5","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1212\/01.wnl.0000318278.41347.94","article-title":"Stroke: the Elixhauser Index for comorbidity adjustment of in-hospital case fatality","volume":"71","author":"Zhu","year":"2008","journal-title":"Neurology."},{"key":"2020110612442952600_ocw181-B6","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1002\/art.21440","article-title":"Comparison of three comorbidity measures for predicting health service use in patients with osteoarthritis","volume":"53","author":"Dominick","year":"2005","journal-title":"Arthritis Rheum."},{"key":"2020110612442952600_ocw181-B7","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1097\/MLR.0b013e31819432e5","article-title":"A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data","volume":"47","author":"van Walraven","year":"2009","journal-title":"Med Care."},{"key":"2020110612442952600_ocw181-B8","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care."},{"key":"2020110612442952600_ocw181-B9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/01.mlr.0000118861.56848.ee","article-title":"Comparison of the Elixhauser and Charlson\/Deyo methods of comorbidity measurement in administrative data","volume":"42","author":"Southern","year":"2004","journal-title":"Med Care."},{"key":"2020110612442952600_ocw181-B10","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/1472-6963-10-140","article-title":"Comparison of different comorbidity measures for use with administrative data in predicting short- and long-term mortality","volume":"10","author":"Chu","year":"2010","journal-title":"BMC Health Serv Res."},{"key":"2020110612442952600_ocw181-B11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/eurpub\/cku221","article-title":"Comparing the performance of the Charlson\/Deyo and Elixhauser comorbidity measures across five European countries and three conditions","volume":"25","author":"Gutacker","year":"2015","journal-title":"Eur J Public Health."},{"key":"2020110612442952600_ocw181-B12","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jclinepi.2011.03.014","article-title":"Accuracy of hospital morbidity data and the performance of comorbidity scores as predictors of mortality","volume":"65","author":"Mnatzaganian","year":"2012","journal-title":"Clin Epidemiol."},{"key":"2020110612442952600_ocw181-B13","unstructured":"Healthcare Cost and Utilization Project (HCUP). https:\/\/www.hcup-us.ahrq.gov\/. 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Creation of Format Library for Elixhauser Comorbidity Groups. https:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/comorbidity\/comformat2012-2015.txt Accessed September 5, 2016."},{"key":"2020110612442952600_ocw181-B18","unstructured":"Healthcare Cost and Utilization Project (HCUP). http:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/comorbidity\/comoanaly2012-2015.txt. Accessed September 5, 2016."},{"key":"2020110612442952600_ocw181-B19","unstructured":"Lix\n              L\n            , SmithM, PitzM. Cancer Data Linkage in Manitoba: Expanding the Infrastructure for Research. http:\/\/mchp-appserv.cpe.umanitoba.ca\/reference\/\/Candata_web_final.pdf#Page=96. Accessed September 12, 2016."},{"key":"2020110612442952600_ocw181-B20","unstructured":"Healthcare Cost and Utilization Project (HCUP). Central Distributor SID: Description of Data Elements. http:\/\/www.hcup-us.ahrq.gov\/db\/vars\/siddistnote.jsp?var=dxn. Accessed September 12, 2016. HCUP retains all diagnoses reported by the states, but truncates the list at 25 in the files it makes available for purchase."},{"key":"2020110612442952600_ocw181-B21","volume-title":"Software Version Changes to ICD-9 and DRG Codes for Calculation of Elixhauser Comorbidities","author":"Healthcare Cost and Utilization Project (HCUP)"},{"key":"2020110612442952600_ocw181-B22","unstructured":"Manitoba Centre for Health Policy. Concept: Elixhauser Comorbidity Index. http:\/\/mchp-appserv.cpe.umanitoba.ca\/viewConcept.php?conceptID=1436. Accessed September 6, 2016."},{"key":"2020110612442952600_ocw181-B23","unstructured":"Healthcare Cost and Utilization Project (HCUP). Introduction to the HCUP Nationwide Readmissions Database (NRD). 2013. https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nrd\/NRD_Introduction_2013.jsp#getstarted. Accessed September 5, 2016."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/24\/4\/845\/34149231\/ocw181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/24\/4\/845\/34149231\/ocw181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:20:13Z","timestamp":1604686813000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/24\/4\/845\/3001935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,16]]},"references-count":23,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2017,2,16]]},"published-print":{"date-parts":[[2017,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocw181","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,7]]},"published":{"date-parts":[[2017,2,16]]}}}