Comparing Charlson Comorbidity Index Scores between Anesthesiologists, Patients, and Administrative Data: A Prospective Observational Study

(1) Background: Patients' comorbidities play an immanent role in perioperative risk assessment. It is unknown how Charlson Comorbidity Indices (CCIs) from different sources compare. (2) Methods: In this prospective observational study, we compared the CCIs of patients derived from patients' self-reports and from physicians' assessments with hospital administrative data. (3) Results: The data of 1007 patients was analyzed. Agreement between the CCI from patients' self-report compared to administrative data was fair (kappa 0.24 [95%CI 0.2-0.28]). Agreement between physicians' assessment and the administrative data was also fair (kappa 0.28 [95%CI 0.25-0.31]). Physicians' assessment and patients' self-report had the best agreement (kappa 0.33 [95%CI 0.30-0.37]). The CCI calculated from the administrative data showed the best predictability for in-hospital mortality (AUROC 0.86 [95%CI 0.68-0.91]), followed by equally good prediction from physicians' assessment (AUROC 0.80 [95%CI 0.65-0.94]) and patients' self-report (AUROC 0.80 [95%CI 0.75-0.97]). (4) Conclusions: CCIs derived from patients' self-report, physicians' assessments, and administrative data perform equally well in predicting postoperative in-hospital mortality.