Charlson comorbidity index adjustment in intracerebral hemorrhage.
Charlson comorbidity index adjustment in intracerebral hemorrhage.
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DOI：
10.1161/strokeaha.111.617639
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发表时间：
2011-10
期刊：
影响因子：
8.3
通讯作者：
Hemphill JC 3rd
中科院分区：
文献类型：
--
作者：
Bar B;Hemphill JC 3rd
脑出血（ICH）预后预测模型的既往研究未系统纳入共病条件的调整。本研究的目的是评估Charlson合并症指数（CCI）是否与脑出血患者的早期死亡率和长期功能结局相关。我们对2001年6月1日至2004年5月31日在UCSF两家医院住院的ICH患者的前瞻性观察队列进行了回顾性分析。记录ICH评分和早期护理限制的使用。使用改良兰金量表（mRS）评估12个月的结局。CCI是使用出院ICD-9 CM代码和从标准化病例报告表中获得的患者病史得出的。在这个243例ICH患者的队列中，共病情况很常见，CCI评分范围为0 - 12。只有29%的CCI评分较高（≥3）的患者12个月mRS评分达到3或更好，而CCI评分为0的患者为48%（p=0.02）。CCI评分独立预测12个月的功能结局，CCI越高影响越大（CCI=2，OR=2.3，p=0.06; CCI ≥3，OR=3.5，p=0.001）。CCI测量的共病医学状况独立影响ICH后的结局。未来的ICH结局研究应考虑合并症对患者结局的影响。
Prior studies of intracerebral hemorrhage (ICH) outcome prediction models have not systematically included adjustment for comorbid conditions. The purpose of this study was to assess whether the Charlson Comorbidity Index (CCI), was associated with early mortality and long-term functional outcome in patients with intracerebral hemorrhage. We performed a retrospective analysis on a prospective observational cohort of patients with ICH admitted to two UCSF hospitals from 6/1/2001-5/31/2004. Components of the ICH Score and use of early care limitations were recorded. Outcome was assessed using the modified Rankin Scale (mRS) out to 12-months. The CCI was derived using hospital discharge ICD-9 CM codes and patient history obtained from standardized case report forms. In this cohort of 243 ICH patients comorbid conditions were common, with CCI scores ranging from 0 to 12. Only 29% of patients with high CCI scores (≥3) achieved a 12-month mRS score of 3 or better compared with 48% of patients with CCI scores of 0 (p=0.02). CCI score was independently predictive of 12-month functional outcome, with higher CCI having a greater impact (CCI=2, OR=2.3, p=0.06; CCI ≥3, OR=3.5, p=0.001). Comorbid medical conditions as measured by the CCI independently influence outcome after ICH. Future ICH outcome studies should account for the impact of comorbidities on patient outcome.