Charlson comorbidity index helps predict the risk of mortality for patients with type 2 diabetic nephropathy
Charlson comorbidity index helps predict the risk of mortality for patients with type 2 diabetic nephropathy
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DOI：
10.1631/jzus.b1300109
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发表时间：
2014-01-01
影响因子：
5.1
通讯作者：
Liu, Fang
中科院分区：
文献类型：
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作者：
Huang, You-qun;Gou, Rong;Liu, Fang
我们的目的是检验Charlson共病指数(CCI)对2型糖尿病肾病(DN)患者死亡率的预测作用。根据CCI评分，共病的严重程度被分为三个等级：轻度，CCI评分1-2；中度，CCI评分3-4；重度，CCI评分千分之五。通过Logistic回归分析和单因素方差分析(ANOVA)确定影响死亡率的因素和CCI分层组间的差异。采用Kaplan-Meier分析评估CCI对死亡率的影响。本研究共纳入533例2型糖尿病肾病患者，所有患者均有共病(CCI评分1分)，死亡238例(44.7%)。病死率随CCI评分增加而增加：CCI评分在1~2分者占21.0%(50/238)，CCI评分在3~4分者占56.7%(135/238)，CCI评分在千分之5以下者占22.3%(53/238)。Logistic回归分析显示CCI评分、血红蛋白和血清白蛋白是潜在的死亡率预测因子(P<；0.05)。单因素方差分析显示，与CCI评分较低的患者相比，CCI评分较高的糖尿病肾病患者的血红蛋白水平较低，血清肌酐水平较高，病死率较高。Kaplan-Meier曲线显示，随着CCI评分和死亡率的升高，生存时间减少。综上所述，CCI为2型糖尿病肾病的并发症分类和死亡率预测提供了一种简单、易用、有效的方法。提高对2型糖尿病肾病患者潜在并发症的认识可能有助于对这种复杂疾病的深入了解，并通过更早和更有效地识别和治疗患者来改善预后。
Our intent is to examine the predictive role of Charlson comorbidity index (CCI) on mortality of patients with type 2 diabetic nephropathy (DN). Based on the CCI score, the severity of comorbidity was categorized into three grades: mild, with CCI scores of 1-2; moderate, with CCI scores of 3-4; and severe, with CCI scores a parts per thousand yen5. Factors influencing mortality and differences between groups stratified by CCI were determined by logistical regression analysis and one-way analysis of variance (ANOVA). The impact of CCI on mortality was assessed by the Kaplan-Meier analysis. A total of 533 patients with type 2 DN were enrolled in this study, all of them had comorbidity (CCI score > 1), and 44.7% (238/533) died. The mortality increased with CCI scores: 21.0% (50/238) patients with CCI scores of 1-2, 56.7% (135/238) patients with CCI scores of 3-4, and 22.3% (53/238) patients with CCI scores a parts per thousand yen5. Logistical regression analysis showed that CCI scores, hemoglobin, and serum albumin were the potential predictors of mortality (P < 0.05). One-way ANOVA analysis showed that DN patients with higher CCI scores had lower levels of hemoglobulin, higher levels of serum creatinine, and higher mortality rates than those with lower CCI scores. The Kaplan-Meier curves showed that survival time decreased when the CCI scores and mortality rates went up. In conclusion, CCI provides a simple, readily applicable, and valid method for classifying comorbidities and predicting the mortality of type 2 DN. An increased awareness of the potential comorbidities in type 2 DN patients may provide insights into this complicated disease and improve the outcomes by identifying and treating patients earlier and more effectively.