Comprehensive Assessment of Comboridity in Clinical Practice: Methodical Approaches and Practical Use

Abstract

Aim: to evaluate current approaches to the assessment of comorbidity in clinical practice and determine the prevalence of comorbidities in patients with coronary artery disease (CAD) who underwent coronary artery stenting.
 Material and methods. We performed a retrospective analysis of data from electronic medical records of 150 CAD patients below 75 yrs having undergone myocardial revascularization via percutaneous coronary intervention (coronary artery stenting). All of them were under the monitoring of the cardiologists of the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. Comorbidity assessment was performed via diseases count; we have dealt only with diseases that are included in the Charlson Comorbidity Index (ССІ) and Combined Age Charlson Comorbidity Index (СА-ССІ) calculation proceeding. We used statistical software programs (Statistica v. 6.0) and Microsoft Excel 2007 applications for data analysis.
 Results. According to data of the medical records the most common comorbidities (among those used to calculate CCI and CA-CCI) in patients with CAD below 75 yrs who underwent coronary artery stenting were cerebrovascular disease (83.3 ± 3.0%), peripheral vascular diseases (42,7±4,0%), type 2 diabetes mellitus, and mild liver diseases (24,0±3,6%). It was found that the number of comorbid diseases in patients having been examined ranged from 2 to 7, with an average of 3,9±0,1. The mean number of diseases in patients of different ages did not differ significantly. The average CA-CCI value increased from 4,4±0,2 points in patients who had two diseases to 12,7±1,1 points in those with seven ones (р<0,05).
 Conclusions. Our study revealed a high prevalence of comorbidities in patients with CAD below 75 yrs who underwent coronary artery stenting. The use of CA-CCI allowed making a comprehensive assessment of patient’s conditions