Araştırma Makalesi

Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital

Cilt: 47 Sayı: 1 31 Mart 2022
PDF İndir
EN TR

Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital

Abstract

Purpose: In most countries, there is an ever-increasing admission rate of the elderly population into emergency departments (EDs). In particular, these elderly patients differ from younger patients because they have multiple comorbidities that affect the functionality and quality of life. The goal of this study is to reveal whether the Charlson comorbidity index (CCI) foresee the short- and long-term prognosis of the super-elderly patient population. Materials and Methods: The study was a descriptive, retrospective analysis of emergency department (ED) admissions by patients over 85 years of age and admitted to the Canakkale Onsekiz Mart University (COMU) Hospital between 2013 and 2018. The demographic data of the patients were analyzed according to CCI. Cox-regression analyses were conducted to determine whether the variables affected mortality. Results: A total of 1142 patients aged 85 and older (507 men, 635 women) with a mean age of 86.96±2.49 were included in the study. According to the multivariable Cox regression analysis male gender, CCI ≥6 and ICU admission were significantly associated with increased mortality rates Conclusion: The CCI predicts short and long-term prognosis in acutely ill, hospitalized super-elderly patients. The CCI could be used to select super-elderly patients at admission as an indicator of improvement at hospital discharge.

Keywords

Charlson comorbidity index , emergency department , hospitalization , mortality , aged 80 and over

Kaynakça

  1. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018;13:e0203316.
  2. Heeren P, Hendrikx A, Ceyssens J, Devriendt E, Deschodt M, Desruelles D et al. Structure and processes of emergency observation units with a geriatric focus: a scoping review. BMC Geriatr. 2021;21:95.
  3. Blomaard LC, Mooijaart SP, Bolt S, Lucke JA, de Gelder J, Booijen AM, Gussekloo J, de Groot B. Feasibility and acceptability of the 'Acutely Presenting Older Patient' screener in routine emergency department care. Age Ageing. 2020;49:1034-41.
  4. Berning MJ, Oliveira J E Silva L, Suarez NE, Walker LE, Erwin P, Carpenter CR et al. Interventions to improve older adults' emergency department patient experience: A systematic review. Am J Emerg Med. 2020;38:1257-69.
  5. Dresden SM, Lo AX, Lindquist LA, Kocherginsky M, Post LA, French DD et al. The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: Protocol for a randomized controlled trial. Contemp Clin Trials. 2020:106125.
  6. Covino M, Petruzziello C, Onder G, Migneco A, Simeoni B, Franceschi F, Ojetti V. A 12-year retrospective analysis of differences between elderly and oldest old patients referred to the emergency department of a large tertiary hospital. Maturitas. 2019;120:7-11.
  7. Frenkel WJ, Jongerius EJ, Mandjes-van Uitert MJ, van Munster BC, de Rooij SE. Validation of the Charlson comorbidity index in acutely hospitalized elderly adults: a prospective cohort study. J Am Geriatr Soc. 2014:62:342–6.
  8. Le Lagadec MD, Dwyer T. Scoping review: The use of early warning systems for the identification of in-hospital patients at risk of deterioration. Aust Crit Care. 2017;30:211–8.
  9. Adams SV, Mader MJ, Bollinger MJ, Wong ES, Hudson TJ, Littman AJ. Utilization of interactive clinical video telemedicine by rural and urban veterans in the veterans health administration health care system. J Rural Health. 2019;35(3):308-18.
  10. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.