Prognostic value of Charlson Comorbidity Index in the elderly with a cardioverter defibrillator implantation

Poupin, Pierre; Bouleti, Claire; Degand, Bruno; Pocard, Marc; Gal, François Le; Bureau, Marie-Laure; Alos, Benjamin; Roumegou, Pierre; Christiaens, Luc; Ingrand, Pierre; Garcia, Rodrigue

doi:10.1016/j.ijcard.2020.03.060

Cited by 15 publications

(20 citation statements)

References 26 publications

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“…3) Patients with low comorbidity burden have a similar risk for excess of LOS and mortality as younger patients. Our findings are in line with previous studies that found a higher mortality for patients with a CCI > 1 in elderly patients undergoing implantable cardioverter defibrillator (ICD) implantation and elderly patients that underwent PM implantation [4,5]. We extend these findings to LOS and compared the results of elderly patients to the outcomes of younger patients.…”

Section: Discussionsupporting

confidence: 90%

“…On the other hand, the elderly and extreme elderly are the most rapidly growing segments of the population in developed countries and pacemakers are commonly implanted in this population [4]. However, recent studies suggest that comorbidity may have an equal, if not greater, effect on LOS and mortality as age in a variety of clinical scenarios [5,6]. The objective of this study was to evaluate the impact of comorbidity on LOS and mortality, as compared to age, in patients undergoing new pacemaker implantation.…”

Section: Introductionmentioning

confidence: 99%

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Comorbidities Vs Age as Major Predictor of Prolonged Length of in-Hospital Stay in Patients Undergoing New Pacemaker Implantation

Marschall¹,

Carnevali²,

Sánchez³

et al. 2020

JICOA

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Traditionally, advanced age has been considered a major factor for increased LOS and healthcare costs. However, recent studies suggest that comorbidity may have an equal, if not greater, effect on LOS and mortality as age in a variety of clinical scenarios. The elderly are the most rapidly growing part of the population in developed countries and pacemakers (PM) are commonly implanted in this population. In this retrospective study, we aimed to evaluate the impact of comorbidity on LOS and mortality, as compared to age, in patients undergoing new PM implantation. 257 elective and non-elective patients that underwent new PM implantation were included in the study. The median follow-up time was 20 (15-25) months. A Charlson comorbidity index (CCI) > 1 resulted to be a significant predictor for the excess of LOS, whereas age did not significantly predict excess of LOS. Elderly patients (age > 75 years) with low comorbidity burden (CCI < 1) showed no significant differences with regards to LOS and mortality when compared to younger patients. Considering the findings of our study, when considering patients for PM implantation, comorbidity burden rather than age should be the driving factor in the approach of indication of PM implantation.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Comorbidities Vs Age as Major Predictor of Prolonged Length of in-Hospital Stay in Patients Undergoing New Pacemaker Implantation

Marschall¹,

Carnevali²,

Sánchez³

et al. 2020

JICOA

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“…In this light, it seems rational to examine all SpD patients for mSpD, as there does not appear to be an easy metric for distinguishing between the two groups. Although generally the number and severity of comorbidities are linked to poorer patient outcomes, our data contradict the hypothesis that there is a higher risk of mSpD associated with these factors [18,19].…”

Section: Discussioncontrasting

confidence: 88%

Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

Henkelmann

Denecke

Pieroh

et al. 2021

BMC Musculoskelet Disord

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Background Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results uSpD was detected by MRI in 69 of 79 patients (87%). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

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Section: Discussioncontrasting

confidence: 88%

Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: A Retrospective Observational Study

Henkelmann

Denecke

Pieroh

et al. 2020

Preprint

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Background:Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for an magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods:We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions:Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

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Prognostic value of Charlson Comorbidity Index in the elderly with a cardioverter defibrillator implantation

Cited by 15 publications

References 26 publications

Comorbidities Vs Age as Major Predictor of Prolonged Length of in-Hospital Stay in Patients Undergoing New Pacemaker Implantation

Comorbidities Vs Age as Major Predictor of Prolonged Length of in-Hospital Stay in Patients Undergoing New Pacemaker Implantation

Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: A Retrospective Observational Study

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