With advances in the effectiveness of treatment and disease management, the contribution of chronic comorbid diseases (comorbidities) found within the Charlson comorbidity index to mortality is likely to have changed since development of the index in 1984. The authors reevaluated the Charlson index and reassigned weights to each condition by identifying and following patients to observe mortality within 1 year after hospital discharge. They applied the updated index and weights to hospital discharge data from 6 countries and tested for their ability to predict in-hospital mortality. Compared with the original Charlson weights, weights generated from the Calgary, Alberta, Canada, data (2004) were 0 for 5 comorbidities, decreased for 3 comorbidities, increased for 4 comorbidities, and did not change for 5 comorbidities. The C statistics for discriminating in-hospital mortality between the new score generated from the 12 comorbidities and the Charlson score were 0.825 (new) and 0.808 (old), respectively, in Australian data (2008), 0.828 and 0.825 in Canadian data (2008), 0.878 and 0.882 in French data (2004), 0.727 and 0.723 in Japanese data (2008), 0.831 and 0.836 in New Zealand data (2008), and 0.869 and 0.876 in Swiss data (2008). The updated index of 12 comorbidities showed good-to-excellent discrimination in predicting in-hospital mortality in data from 6 countries and may be more appropriate for use with more recent administrative data.

/pdf/updating-and-validating-the-charlson-comorbidity-index-and-u1djuhty32.pdf

Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 Countries

https://cronfa.swan.ac.uk/Record/cronfa26231/Download/0026231-20072016164543.pdf

Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Maternal morbid obesity and the risk of adverse pregnancy outcome

https://idph.iowa.gov/Portals/1/userfiles/35/Factors%20that%20May%20Contribute%20to%20Stillbirth.pdf

Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis

Autism spectrum disorder.

Amniotic fluid (AF) is a complex substance essential to fetal well-being. This article reviews recent discoveries and the current understanding of the origin and circulation of AF and its nutritive, protective, and diagnostic functions. Future directions for AF research are also discussed.

Amniotic fluid: not just fetal urine anymore.

The cost of prematurity: quantification by gestational age and birth weight.

Obstetric anal sphincter lacerations.

Accuracy of obstetric diagnoses and procedures in hospital discharge data

https://pedclerk.bsd.uchicago.edu/sites/pedclerk.uchicago.edu/files/uploads/1611.pdf

William M. Gilbert

Papers

Amniotic fluid: not just fetal urine anymore.

The cost of prematurity: quantification by gestational age and birth weight.

Obstetric anal sphincter lacerations.

Accuracy of obstetric diagnoses and procedures in hospital discharge data

Associated factors in 1611 cases of brachial plexus injury.