The prognostic value of the Charlson comorbidity index in aged patients with intracerebral hemorrhage

Abstract

Background Comorbidities are common in aged intracerebral hemorrhage patients. The purpose of this study was to assess whether the Charlson Comorbidity Index (CCI) was associated with in-hospital death and short-term functional outcome in elderly patients (age ≥ 70) with intracerebral hemorrhage (ICH). Methods This was a retrospective cohort of aged ICH patients (≥70 years old) admitted within 24 hours of ICH onset. The CCI was derived using hospital discharge ICD-9 CM codes and patient history obtained from standardized case report forms. Multivariable logistic regression was used to determine the independent effect of the CCI score on clinical outcomes. Results In this cohort of 248 aged ICH patients, comorbid conditions were common, with CCI scores ranging from 2 to 12. Logistic regression showed that the CCI score was independently predictive of 1-month functional outcome (OR = 1.642, P < 0.001) and in-hospital death (OR = 1.480, P = 0.003). Neither ICH volume nor the presence of IVH was an independent predictive factor for 1-month functional outcome or in-hospital mortality (P < 0.05). Conclusion Comorbid medical conditions as assessed by the CCI independently influence short-term outcomes in aged ICH patients. The characteristics of the hematoma itself, such as ICH volume and the presence of IVH, seem to have a reduced effect on it.

Determinants of acute and subacute case-fatality in elderly patients with hypertensive intracerebral hemorrhage

“…More importantly, in HICH patients, poor functional outcome was independently correlated with larger hematoma volume and lower GCS score. Additionally, in multiple studies, a larger hematoma volume and lower GCS score were associated with increased morbidity and mortality [ 20 , [23] , [24] , [25] ].…”

The Role of Aging in Intracerebral Hemorrhage

“…Moreover, Zhang et al’s study on 248 ICH patients aged 70 years and above found that certain pulmonary diseases (such as chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary fibrosis) and cerebrovascular diseases (such as previous IS and transient ischemic attack) were common comorbidities in ICH, significantly impacting patient prognosis and treatment strategies. The Charlson Comorbidity Index (CCI) is used to quantify the impact of these comorbidities and is associated with short-term prognosis and hospital mortality in patients [ 28 ].…”

“…The accumulation of these changes can result in thickening and stiffening of the walls of small cerebral arteries and constriction of their lumens, ultimately reducing vascular wall elasticity and increasing intraluminal pressure, leading to rupture and bleeding [30] (Figure 2). Index (CCI) is used to quantify the impact of these comorbidities and is associated with short-term prognosis and hospital mortality in patients [28].…”

Intracerebral Hemorrhage Score as a Prognosis Prediction of Spontaneous Intracerebral Hemorrhage at RSI Surabaya Jemursari

“…The hematoma's characteristics, such as ICH volume and the presence of IVH, appear to reduce its effect. 16…”