Evaluation of Charlson's comorbidity index in elderly living in nursing homes
Evaluation of Charlson's comorbidity index in elderly living in nursing homes
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DOI：
10.1016/s0895-4356(02)00485-7
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发表时间：
2002-11-01
影响因子：
7.2
通讯作者：
Van den Akker, M
中科院分区：
文献类型：
--
作者：
Buntinx, F;Niclaes, L;Van den Akker, M
本文的目的是验证Charlson合并症指数对老年人短期死亡率或发病率的预测价值。研究设计是一项队列研究，比较了基线时具有不同合并症水平的住院老年人的生存率和住院率。研究背景为16个佛兰芒老年疗养院，受试者为2，727名居民，其中2，624名居民的完整数据可用。结局指标为考克斯回归分析得出的风险比，比较中度和高度与低度合并症患者的6个月生存率。比较同一组存活患者随访期间至少一次住院的发生率的多元logistic回归分析得出的比值比。经年龄组校正的死亡率在中度合并症患者中显著增加（HR = 2.00），在高合并症患者中甚至更高（HR = 3.62）。两组的住院率更高（OR分别为1.54和2.19），仅最高组达到统计学显著性。调整年龄、性别、活动状态和定向障碍并没有改变总体情况。Charlson合并症指数是住院老年患者短期死亡率的预测指标，在较小程度上，也是住院率的预测指标。这些结果支持其作为一种措施，引入合并症作为一个协变量的纵向研究与老年人口。(C)2002年爱思唯尔科技有限公司All rights reserved.
The object of this article was to validate the predictive value of Charlson's comorbidity index for the prediction of short-term mortality or morbidity in elderly people. The design was a cohort study comparing survival and hospitalization in institutionalized elderly people with different levels of comorbidity at baseline. The setting was 16 Flemish nursing homes for the elderly, The subjects were 2,727 inhabitants of which full data were available for 2,624, The outcome measures were hazard ratios resulting from Cox regression analysis, comparing 6 months survival in patients with moderate and a high level to low level of comorbidity. Odds ratios resulting from multiple logistic regression analysis comparing the occurrence of at least one hospitalization during the follow-up period in surviving patients of the same groups. Mortality adjusted for age group was significantly increased in patients with a moderate (HR = 2.00) and even more in those with a high level (HR = 3.62) of comorbidity. Hospitalization was more frequent in both groups (OR = 1.54 and 2 19, respectively), with statistical significance only being reached for the highest group. Adjustment for age, gender, mobility status, and disorientation did not change the general picture. Charlson's comorbidity index is a predictor of short-term mortality in institutionalized elderly patients and, to a lesser extend, also of hospitalization. These results support its use as a measure for introducing comorbidity as a covariable in longitudinal studies with a geriatric population. (C) 2002 Elsevier Science Inc. All rights reserved.