Charlson Comorbidity Index can add prognostic information to Rapid Emergency Medicine Score as a predictor of long-term mortality

2005 ◽  
Vol 12 (5) ◽  
pp. 220-224 ◽  
Author(s):  
Thomas Olsson ◽  
Andreas Terent ◽  
Lars Lind
Keyword(s):  
Emergency Medicine ◽  
Charlson Comorbidity Index ◽  
Prognostic Information ◽  
Comorbidity Index ◽  
Long Term Mortality

scholarly journals Charlson Comorbidity Index does not predict long-term mortality in elderly subjects with chronic heart failure

2009 ◽  
Vol 38 (6) ◽  
pp. 734-740 ◽  
Author(s):  
G. Testa ◽  
F. Cacciatore ◽  
G. Galizia ◽  
D. Della-Morte ◽  
F. Mazzella ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Charlson Comorbidity Index ◽  
Elderly Subjects ◽  
Comorbidity Index ◽  
Long Term Mortality

scholarly journals Charlson Comorbidity Index: A Critical Review of Clinimetric Properties

2022 ◽  
Vol 91 (1) ◽  
pp. 8-35
Author(s):  
Mary E. Charlson ◽  
Danilo Carrozzino ◽  
Jenny Guidi ◽  
Chiara Patierno
Keyword(s):  
Critical Review ◽  
Charlson Comorbidity Index ◽  
Concurrent Validity ◽  
Assessment Tool ◽  
Self Report ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Comorbidity Index ◽  
Long Term Mortality

The present critical review was conducted to evaluate the clinimetric properties of the Charlson Comorbidity Index (CCI), an assessment tool designed specifically to predict long-term mortality, with regard to its reliability, concurrent validity, sensitivity, incremental and predictive validity. The original version of the CCI has been adapted for use with different sources of data, ICD-9 and ICD-10 codes. The inter-rater reliability of the CCI was found to be excellent, with extremely high agreement between self-report and medical charts. The CCI has also been shown either to have concurrent validity with a number of other prognostic scales or to result in concordant predictions. Importantly, the clinimetric sensitivity of the CCI has been demonstrated in a variety of medical conditions, with stepwise increases in the CCI associated with stepwise increases in mortality. The CCI is also characterized by the clinimetric property of incremental validity, whereby adding the CCI to other measures increases the overall predictive accuracy. It has been shown to predict long-term mortality in different clinical populations, including medical, surgical, intensive care unit (ICU), trauma, and cancer patients. It may also predict in-hospital mortality, although in some instances, such as ICU or trauma patients, the CCI did not perform as well as other instruments designed specifically for that purpose. The CCI thus appears to be clinically useful not only to provide a valid assessment of the patient’s unique clinical situation, but also to demarcate major diagnostic and prognostic differences among subgroups of patients sharing the same medical diagnosis.

scholarly journals Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome

2020 ◽  
Vol 9 (12) ◽  
pp. 3882
Author(s):  
Thomas Stiermaier ◽  
Kira Busch ◽  
Torben Lange ◽  
Toni Pätz ◽  
Moritz Meusel ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Takotsubo Syndrome ◽  
Prognostic Information ◽  
Long Term Mortality

Cardiac magnetic resonance (CMR)-derived left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information on various cardiovascular diseases but has not yet been investigated comprehensively in patients with Takotsubo syndrome (TS). This study evaluated the prognostic value of feature tracking (FT) GLS, tissue tracking (TT) GLS, and fast manual long axis strain (LAS) in 147 patients with TS, who underwent CMR at a median of 2 days after admission. Long-term mortality was assessed 3 years after the acute event. In contrast to LV ejection fraction and tissue characteristics, impaired FT-GLS, TT-GLS and fast manual LAS were associated with adverse outcome. The best cutoff points for the prediction of long-term mortality were similar with all three approaches: FT-GLS −11.28%, TT-GLS −11.45%, and fast manual LAS −10.86%. Long-term mortality rates were significantly higher in patients with FT-GLS > −11.28% (25.0% versus 9.8%; p = 0.029), TT-GLS > −11.45% (20.0% versus 5.4%; p = 0.016), and LAS > −10.86% (23.3% versus 6.6%; p = 0.014). However, in multivariable analysis, diabetes mellitus (p = 0.001), atrial fibrillation (p = 0.001), malignancy (p = 0.006), and physical triggers (p = 0.006) outperformed measures of myocardial strain and emerged as the strongest, independent predictors of long-term mortality in TS. In conclusion, CMR-based longitudinal strain provides valuable prognostic information in patients with TS, regardless of the utilized technique of assessment. Long-term mortality, however, is mainly determined by comorbidities.

Utility of the Charlson Comorbidity Index Computed from Routinely Collected Hospital Discharge Diagnosis Codes

2000 ◽  
Vol 39 (01) ◽  
pp. 7-11 ◽  
Author(s):  
L. L.-Y. Lim ◽  
R. L. O’Connell
Keyword(s):  
Charlson Comorbidity Index ◽  
Model Fit ◽  
Ratio Test ◽  
Discharge Diagnosis ◽  
Term Survival ◽  
Additional Information ◽  
Diagnosis Codes ◽  
Comorbidity Index ◽  
Informed Patient

Abstract:This study aims to determine whether the Charlson comorbidity index computed from ICD-9-CM discharge diagnosis codes adds additional information to a model containing adjustment for more informed patient details (e.g., disease severity and history), besides solely age and sex, when predicting long-term survival. We conducted a retrospective cohort study of patients admitted to hospital for suspected acute myocardial infarction. Index scores were calculated by applying the D’Hoore et al. algorithm (1993). The index significantly improved the model fit (likelihood ratio test: p <0.001). The D’Hoore-adapted Charlson index is a useful comorbidity risk adjustment tool when applied to AMI and angina patients.

scholarly journals QT prolongation predicts short-term mortality independent of comorbidity

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1254-1260 ◽  
Author(s):  
Charlotte Gibbs ◽  
Jacob Thalamus ◽  
Doris Tove Kristoffersen ◽  
Martin Veel Svendsen ◽  
Øystein L Holla ◽  
...  
Keyword(s):  
Main Diagnosis ◽  
Short Term ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Comorbidity Index ◽  
Short And Long Term ◽  
Mortality Hazard Ratio ◽  
Long Term Mortality

Abstract Aims A prolonged corrected QT interval (QTc) ≥500 ms is associated with high all-cause mortality in hospitalized patients. We aimed to explore any difference in short- and long-term mortality in patients with QTc ≥500 ms compared with patients with QTc <500 ms after adjustment for comorbidity and main diagnosis. Methods and results Patients with QTc ≥500 ms who were hospitalized at Telemark Hospital Trust, Norway between January 2007 and April 2014 were identified. Thirty-day and 3-year all-cause mortality in 980 patients with QTc ≥500 ms were compared with 980 patients with QTc <500 ms, matched for age and sex and adjusting for Charlson comorbidity index (CCI), previous admissions, and main diagnoses. QTc ≥500 ms was associated with increased 30-day all-cause mortality [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.38–2.62; P < 0.001]. There was no significant difference in mortality between patients with QTc ≥500 ms and patients with QTc <500 ms who died between 30 days and 3 years; 32% vs. 29%, P = 0.20. Graded CCI was associated with increased 3-year all-cause mortality (CCI 1–2: HR 1.62, 95% CI 1.34–1.96; P < 0.001; CCI 3–4: HR 2.50, 95% CI 1.95–3.21; P < 0.001; CCI ≥5: HR 3.76, 95% CI 2.85–4.96; P < 0.001) but was not associated with 30-day all-cause mortality. Conclusion QTc ≥500 ms is a powerful predictor of short-term mortality overruling comorbidities. QTc ≥500 ms also predicted long-term mortality, but this effect was mainly caused by the increased short-term mortality. For long-term mortality, comorbidity was more important.

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