The prognostic role of Charlson comorbidity index for critically ill elderly patients

Year 2020, , 67 - 72, 04.01.2020

Abdulkerim Yıldız , Ali Yiğt Ali Ramazan Benli

https://doi.org/10.18621/eurj.451391

Cited By: 8

Abstract

Objectives:
Comorbidities
represent a risk factor for adverse events in several critical illnesses. The
aim of this study was to identify the relationship between the Charlson
Comorbidity Index (CCI) with mortality and length of stay (LOS) in critically
ill elderly patients.

Methods: A
retrospective analysis was made of patients admitted to our tertiary adult
intensive care unit (ICU) between January 2015 and January 2016. The impact of
comorbidity was evaluated with the CCI. Other required data were retrieved from
the patients' follow-up records.

Results: The
study included a total of 251 patients. The mean age was 78.79 ± 6.70 years. The total
mortality rate was 41.0%. The most common cause for admission was sepsis and
acute respiratory failure (18.3% vs 18.3%). The median APACHE II score was
significantly higher in non-survivors than survivors (31.0 [13.0-47.0] vs 21.0
[9.0-40.0]; p < 0.01). The median
CCI was 2.0 (0.0-7.0) for survivors and 3.0 (1.0-10.0) for non-survivors. The
CCI of non-survivors was significantly higher than that of survivors (p = 0.005). Patients with CCI > 3 had
higher mortality than those with CCI ≤ 3
(p < 0.05). The odds ratio of the
APACHE II score for mortality was 1.214 (95% CI: 1.154-1.276), and for CCI it
was 1.320
(95% CI: 1.088-1.602). There was a significant positive correlation between CCI
and LOS (r=0.147; p = 0.020).

Conclusions: CCI
is strongly associated with both mortality and LOS. It can be used as a
prognostic marker for elderly patients in critical care. 

Keywords

Charlson comorbidity index, older patients, critically ill, mortality

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