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Table 1. Clinical Characteristics of Hospitalized Pediatric Patients, Stratified by In-Hospital Mortality Status.

From: Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan

Hospital survival group (N=1,962,468) In-hospital mortality group (N=6,492) P-value
Sex (male) 1,128,908 57.5% 3,875 59.7% <0.001
Age (years, median, IQR) 8 5-13 11 6-15 <0.001
Age (years)
　3-5 639,177 32.6% 1,402 21.6% <0.001
　6-11 685,880 34.9% 1,938 29.9%
　12-17 637,411 32.5% 3,152 48.6%
Body mass index
　Underweight 282,348 14.4% 1,487 22.9% <0.001
　Normal 1,328,987 67.7% 2,120 32.7%
　Overweight and obesity 174,426 8.9% 558 8.6%
　Missing 176,707 9.0% 2,327 35.8%
Use of ambulance on admission
　No 1,768,577 90.1% 2,667 41.1% <0.001
　Yes 193,229 9.8% 3,804 58.6%
　Missing 662 0.0% 21 0.3%
Unscheduled admission
　No 911,515 46.4% 1,213 18.7% <0.001
　Yes 1,050,277 53.5% 5,254 80.9%
　Missing 676 0.0% 25 0.4%
Comorbidities
　Neurological and neuromuscular 62,258 3.2% 1,393 21.5% <0.001
　Cardiovascular 37,840 1.9% 863 13.3% <0.001
　Respiratory 145,696 7.4% 304 4.7% <0.001
　Renal and urologic 5,543 0.3% 84 1.3% <0.001
　Gastrointestinal 37,409 1.9% 358 5.5% <0.001
　Hematologic and immunologic 25,770 1.3% 722 11.1% <0.001
　Metabolic 145,056 7.4% 634 9.8% <0.001
　Other congenital and genetic 14,947 0.8% 209 3.2% <0.001
　Malignancy 10,012 0.5% 494 7.6% <0.001
　Premature and neonatal 628 0.0% 17 0.3% <0.001
　Use of medical devices 3,878 0.2% 144 2.2% <0.001
　Transplantation 2,788 0.1% 167 2.6% <0.001
Charlson Comorbidity Index (mean, SD) 0.11 0.39 0.52 1.42 <0.001
Total number of CCC　(mean, SD) 0.05 0.26 0.45 0.72 <0.001
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Table 2. Regression Coefficients and Assigned Weights for the 12 Primary Comorbidity Categories for Predicting In-Hospital Mortality.

From: Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan

Category Regression coefficients 95% CI p-value Assigned weight
Neurological and neuromuscular 1.954 1.884 - 2.024 < 0.001 8
Cardiovascular 1.547 1.460 - 1.634 < 0.001 6
Respiratory -0.628 -0.760 - -0.497 < 0.001 -3
Renal and urologic 0.007 -0.283 - 0.297 0.960 0
Gastrointestinal 0.237 0.104 - 0.370 < 0.001 1
Hematologic and immunologic 1.741 1.646 - 1.836 < 0.001 7
Metabolic 0.091 -0.005 - 0.186 0.063 0
Other congenital and genetic 0.862 0.700 - 1.023 < 0.001 3
Malignancy 2.407 2.296 - 2.518 < 0.001 10
Premature and neonatal 1.168 0.655 - 1.681 < 0.001 5
Use of medical devices 0.997 0.775 - 1.219 < 0.001 4
Transplantation 1.516 1.298 - 1.735 < 0.001 6
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Table 3. Discrimination Ability of the Children Comorbidity Score, Total Number of ICD-10-Defined CCC, and Charlson Comorbidity Index.

From: Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan

C-statistics (95% CI) p-value
Developed model Children Comorbidity Score 0.720 (0.707-0.734) Ref
Reference models Total number of ICD-10-defined CCC 0.649 (0.636-0.662) < 0.001
Charlson Comorbidity Index 0.544 (0.533-0.555) < 0.001
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Table 4. Calibration of Children Comorbidity Score and Reference Models.

From: Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan

Calibration in the large index (95% CI) Calibration slope (95% CI)
Developed model Children Comorbidity Score 0.007 (-0.053-0.066) 1.027 (0.981-1.073)
Reference models Total number of ICD-10-defined CCC 0.008 (-0.050-0.067) 1.006 (0.953-1.060)
Charlson Comorbidity Index -0.0003 (-0.061-0.060) 0.937 (0.844-1.031)
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Table 5. Discrimination Ability of the Children Comorbidity Score, Total Number of ICD-10-Defined CCC, and Charlson Comorbidity Index in the Subgroup Analyses.

From: Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan

C-statistics (95% CI) p-value
Age 3-5 years Developed model Children Comorbidity Score 0.744 (0.715-0.772) Ref
Reference models Total number of ICD-10-defined CCC 0.660 (0.633-0.688) < 0.001
Charlson Comorbidity Index 0.534 (0.510-0.558) < 0.001
6-11 years Developed model Children Comorbidity Score 0.749 (0.724-0.775) Ref
Reference models Total number of ICD-10-defined CCC 0.683 (0.657-0.708) < 0.001
Charlson Comorbidity Index 0.553 (0.531-0.574) < 0.001
12-17 years Developed model Children Comorbidity Score 0.681 (0.661-0.701) Ref
Reference models Total number of ICD-10-defined CCC 0.622 (0.604-0.640) < 0.001
Charlson Comorbidity Index 0.553 (0.538-0.567) < 0.001
Sex male Developed model Children Comorbidity Score 0.711 (0.693-0.728) Ref
Reference models Total number of ICD-10-defined CCC 0.643 (0.627-0.660) < 0.001
Charlson Comorbidity Index 0.541 (0.527-0.554) < 0.001
female Developed model Children Comorbidity Score 0.735 (0.713-0.757) Ref
Reference models Total number of ICD-10-defined CCC 0.657 (0.637-0.678) < 0.001
Charlson Comorbidity Index 0.550 (0.532-0.568) < 0.001
BMI Underweight Developed model Children Comorbidity Score 0.810 (0.784-0.837) Ref
Reference models Total number of ICD-10-defined CCC 0.725 (0.697-0.753) < 0.001
Charlson Comorbidity Index 0.607 (0.580-0.634) < 0.001
Normal Developed model Children Comorbidity Score 0.759 (0.735-0.783) Ref
Reference models Total number of ICD-10-defined CCC 0.652 (0.629-0.675) < 0.001
Charlson Comorbidity Index 0.555 (0.535-0.575) < 0.001
Overweight and obesity Developed model Children Comorbidity Score 0.780 (0.735-0.826) Ref
Reference models Total number of ICD-10-defined CCC 0.706 (0.661-0.752) < 0.001
Charlson Comorbidity Index 0.587 (0.545-0.629) < 0.001
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