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AHRQ also derived and evaluated the model fit of a summary Elixhauser score, based on weighting the individual comorbidities, to predict in-hospital mortality and 30-day all-cause re-admissions in hospitalized adults. The set of Elixhauser comorbidity indicators was developed in 1998 but has undergone modifications, including the addition of weighted scores and expanded comorbidity codes. These indices are effective methods to incorporate the influence of comorbid conditions in models designed to assess the risk of in-hospital mortality and readmission using administrative data with limited clinical information, especially when small samples sizes are an issue.Summary comorbidity scores, such as the Charlson comorbidity index and the Elixhauser comorbidity index, can both describe comorbidity burden in observational studies and be used for prognosis. The addition of other commonly used covariates (age, sex, expected payer) improved discrimination modestly. The indices were stable across multiple subsamples defined by demographic characteristics or clinical condition. The c-statistic for our index scores without inclusion of other covariates was 0.777 (95% confidence interval, 0.776-0.778) for the mortality index and 0.634 (95% confidence interval, 0.633-0.634) for the readmissions index. Our index scores performed as well as using all 29 Elixhauser comorbidity variables separately. Model validation was conducted with c-statistics. Odds ratios and index weights were generated for each Elixhauser comorbidity to create a single index score per record for mortality and readmissions. The final models were derived with bootstrapped replications of backward stepwise logistic regressions on each outcome. We used a large analysis file built from all-payer hospital administrative data in the Healthcare Cost and Utilization Project State Inpatient Databases from 18 states in 20. The Elixhauser measures are commonly used in research as an adjustment factor to control for severity of illness. We extend the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data.