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A team from UCLA has developed a new risk scoring tool, the Comorbid Operative Risk Evaluation (CORE) score, designed to account for chronic illnesses that affect surgical patients' mortality risk. By focusing on pre-existing health conditions more specifically related to surgery, the CORE score aims to provide a more accurate method for estimating mortality risk in these patients.
For nearly 40 years, healthcare professionals have relied on the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) to measure the impact of chronic illnesses on patient outcomes. These tools, however, were not designed specifically for surgical populations and often rely on medical billing records, which may not capture the detailed health information required to assess surgical risks. Recognizing this gap, the UCLA researchers developed the CORE score using data from 699,155 patients who underwent 62 different types of surgeries across 14 specialties. The data came from the 2019 National Inpatient Sample (NIS) and was analyzed using ICD-10 codes.
The CORE score categorizes chronic illnesses using Clinical Classifications Software Refined (CCSR) groups and calculates the risk of in-hospital mortality through machine learning models. The final score ranges from 0, representing the lowest risk, to 100, representing the highest. This tool offers a surgery-specific approach to evaluating the role of chronic illness in surgical outcomes, providing more refined insights compared to traditional methods.
Health outcomes research that uses large retrospective databases is increasingly common in surgical research, but existing tools like the CCI and ECI do not always account for the full spectrum of chronic conditions relevant to surgery. The development of the CORE score addresses this limitation by incorporating more detailed health information, which can improve the precision of mortality risk assessments in future research.
By using the CORE score in large-scale studies, researchers hope to improve the analysis of surgical outcomes and ensure that pre-existing conditions are better accounted for when assessing surgical mortality risk. However, the authors of the study emphasize that further research is needed to validate the score and explore its broader applications in clinical practice.