Validation of the Charlson Comorbidity Index in Acutely Hospitalized Elderly Adults: A Prospective Cohort Study
Validation of the Charlson Comorbidity Index in Acutely Hospitalized Elderly Adults: A Prospective Cohort Study
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DOI：
10.1111/jgs.12635
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发表时间：
2014-02-01
影响因子：
6.3
通讯作者：
de Rooij, Sophia E.
中科院分区：
文献类型：
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作者：
Frenkel, Wijnanda J.;Jongerius, Erika J.;de Rooij, Sophia E.
目的 确定查尔森合并症指数 (CCI) 是否可以预测短期和长期死亡率。设计前瞻性队列研究。设置两所大学医院和一所社区医院的医疗部门。参与者为 65 岁及以上的急性住院个体，平均年龄为 77.87.9，其中 45.8% 为男性（n=1,313）。测量对象中的人口特征、日常生活活动信息（修改后） Katz ADL 指数评分）以及入院后 48 小时内收集的疾病相关指标。在三个月和一年时使用自我报告问卷进行随访。功能下降被定义为 12 个月时修正后的 Katz ADL 指数评分较基线下降至少 1 分。从市数据库中收集了 3 个月、1 年和 5 年的死亡率数据。结果根据年龄和性别进行调整后的逻辑回归分析显示，CCI 为 5 或以上的参与者具有较高的 3 个月（优势比 (OR)=3.6，95% 置信区间 (CI)=2.1-6.4）、1 年（OR=7.1，95% CI=4.2-11.9）和5 年死亡率（OR=52.4，95% CI=13.3-206.4）高于 CCI 为 0 的参与者。CCI 评分在 1 到 4 之间的参与者在 3 个月以及 1 和 5 年时的死亡风险也更高。结论 CCI 独立预测急症住院老年人的短期和长期死亡率。
ObjectivesTo determine whether the Charlson Comorbidity Index (CCI) predicts short- and long-term mortality.DesignProspective cohort study.SettingThe medical department of two university hospitals and one community-based hospital.ParticipantsAcutely hospitalized individuals aged 65 and older with a mean age of 77.87.9, 45.8% male (n=1,313).MeasurementsIn eligible persons, information on demographic characteristics, activities of daily living (modified Katz ADL Index score), and disease-related measures was collected within 48hours after admission. Follow-up using self-reporting questionnaires was performed at 3months and 1year. Functional decline was defined as a decline of at least 1 point on the modified Katz ADL Index score at 12months from baseline. Mortality data at 3months and 1 and 5years were collected from the municipal database.ResultsLogistic regression analysis, adjusted for age and sex, showed that participants with a CCI of 5 or more had higher 3-month (odds ratio (OR)=3.6, 95% confidence interval (CI)=2.1-6.4), 1-year (OR=7.1, 95% CI=4.2-11.9), and 5-year (OR=52.4, 95% CI=13.3-206.4) mortality than those with a CCI of 0. Participants with CCI scores between 1 and 4 also had greater mortality risk at 3months and 1 and 5years.ConclusionThe CCI independently predicts short- and long-term mortality in acutely ill hospitalized elderly adults.