Charlson comorbidity index scores and in‐hospital prognosis of patients with severe acute respiratory infections

Abstract

Background Respiratory infections are one of the leading causes of mortality, and comorbid conditions play a significant role in the severity and fatality of these infections. Aims We evaluated the Charlson Comorbidity Index (CCI) score and possible predictors of mortality in hospitalised patients with severe acute respiratory infection (SARI), aiming to test if the CCI is a valid in‐hospital prognostic indicator. Methods Patients older than 14 years, hospitalised from 2010 to 2016 due to SARI by viral infection and who were submitted to respiratory virus testing were included. We assessed comorbidity retrospectively through chart review and calculated four variants of the CCI. Results Of the 291 patients assessed, 72.8% (n = 212) presented comorbidities, and 24% died (n = 70). The most recurrent comorbidities were chronic pulmonary disease (n = 76/212, 36%) and HIV (n = 50/212, 23.6%). The 1994 age‐adjusted CCI predicted in‐hospital mortality in SARI patients (P = 0.04), and HIV was associated with in‐hospital mortality (P = 0.032). Conclusions The comorbidity scores used to assess mortality risk in hospitalised patients with SARI displayed poor results, but HIV infection was considered a marker of severity. However, other factors should be considered in order to compose a score system that allows us to specifically assess the risk of mortality in patients with SARI.

Can Age Adjusted Charlson Comorbidity Index Predict Prognosis in Hospitalised COVID-19 patients?

“…P value of < 0.05 was considered to be statistically significant. study with a similar number of patients to ours however reported that it wasn't a good predictor of outcomes in patients with respiratory failure in general [20] and a large Brazilian study again concluded that it doesn't predict outcomes in patients with severe acute respiratory infections [21].…”

What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

“…The Charlson comorbidity index (CCI) is one of the most widely used comorbidity indexs 39,40 , which consists of 22 conditions 41 , including myocardial infarction, congestive heart failure, peripheral vascular disease, dementia, cerebrovascular disease, chronic lung disease, connective tissue disease, ulcer, chronic liver disease, diabetes, hemiplegia, moderate or severe kidney disease, diabetes with end organ damage, tumor, leukemia, lymphoma, moderate or severe liver disease, malignant tumor, metastasis, and acquired immune deficiency syndrome (AIDS). We used the CCI to quantify the comorbidities since it could predict the inhospital mortality or outcome in patients with severe adults respiratory infection (SARI) and other infections [42][43][44] .…”

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

“…The NEWS was selected in this study as the early warning score because of its high consistency throughout the literature and its implementation in multiple clinical contexts (Abbott et al, 2018 ; Carr et al, 2021 ; Pimentel et al, 2019 ), as is also the case with the ACCI (Setter et al, 2020 ; Shuvy et al, 2020 ; Imam et al, 2020 ), although we are well aware of the existence of several other scores.…”

“…The ACCI (Setter et al, 2020 ; Shuvy et al, 2020 ) used in this study was calculated by using 17 categories of comorbidities, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular accident or transient ischemic attack, dementia, chronic obstructive pulmonary disease, connective tissue disease, peptic ulcer disease, liver disease mild, diabetes mellitus uncomplicated, hemiplegia, moderate to severe chronic kidney disease, diabetes mellitus end‐organ damage, solid tumour localized, leukaemia, lymphoma, liver disease moderate to severe, solid tumour metastatic and AIDS, together with the adjustment provided by age (for each decade after 50 years, add 1 point to total score).…”