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We consider some of the codes listed in Table 17. Table 18 shows the relationship of code 038,
Septicemia by mortality. It shows a 25% mortality rate, higher than any of the mortality levels listed in
Table 1 that define the Charlson Index. There is no question that the occurrence of this disease puts a
patient at high risk of death; yet, the risk will not be counted at all in the Charlson Index. If investigating
hospital quality, it can be argued that Septicemia is most likely nosocomial; that is, the infection was
acquired in the hospital and should, therefore, not count when predicting the likelihood of mortality.
However, it misses the issue of predicting the patients most at risk. Moreover, Septicemia does occur in
the community and the patient can arrive at the hospital with the condition.
While heart failure and COPD are in the Charlson Index, urinary tract disorders are not included,
nor is the code '780' representing general symptoms, meaning that the patient's condition does not yet
have a diagnosis.
Table 19 gives the mortality level for code 197, Secondary malignant neoplasm of respiratory and
digestive systems. It has a mortality rate of 8%, which has a probability sufficiently high to warrant a
weight of two by the Charlson Index standard; it is given a weight of 3 according to Table 1.
Table 20 gives the mortality for code 707, Chronic ulcer of skin. As the lowest associated level of
mortality given in Table 17, it still has a probability higher than those for a Charlson Index weight of
1.
Table 18. Mortality by occurrence of septicemia
Table of code038 by DIED
code038
DIED
Total
Frequency
Col Pct
0
1
0
7676279
98.10
125542
75.11
7801821
1
148578
1.90
41608
24.89
190186
Total
7824857
167150
7992007
Frequency Missing = 3041
Table 19. Mortality by secondary malignant neoplasm
Table of code197 by DIED
code197
DIED
Total
Frequency
Col Pct
0
1
0
7728732
98.77
153351
91.74
7882083
1
96125
1.23
13799
8.26
109924
Total
7824857
167150
7992007
Frequency Missing = 3041
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