Validation of the Charlson Comorbidity Index in Acutely Hospitalized Elderly Adults: A Prospective Cohort Study

Frenkel, Wijnanda J.; Jongerius, Erika J.; Uitert, Miranda J. Mandjes-van; Munster, Barbara C. Van; Rooij, Sophia E. de

doi:10.1111/jgs.12635

Cited by 261 publications

(182 citation statements)

References 27 publications

(48 reference statements)

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“…The CCI independently predicts both short-and long-term mortality in acutely ill hospitalised elderly adults. 25 In our series, the 1-year mortality rate was 16.3%, slightly lower than some studies 17 but not uncommon. 24 This may be partly due to the general health status of our population and may be partly due to differences in the medical system.…”

Section: 22contrasting

confidence: 58%

Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

2015

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Section: 22contrasting

confidence: 58%

Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

2015

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“…21 Median suPAR levels were increased across all comorbidity groups compared with patients who had not been diagnosed with any predefined chronic comorbid condition, and suPAR increased with increasing Charlson score, indicating that suPAR is indeed a marker of disease severity. In support of this, increased suPAR predicts new-onset cardiovascular complications in patients with other chronic diseases.…”

Section: Discussionmentioning

confidence: 86%

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

et al. 2016

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ObjectiveSoluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.MethodsThis registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.ResultsDuring 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.ConclusionsIn this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.

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“…We used these diagnoses to compute CCI scores as a proxy for the preexisting morbidity burden of each patient. The CCI, a validated comorbidity scoring system, includes 19 specific conditions, each given a weighted score from 1 to 6 depending on its correlation with 1-year mortality (17,18). We defined three CCI levels: low (CCI scoreZ0), medium (CCI scoreZ1-2) and high (CCI score O2).…”

Section: Diagnostic Groupsmentioning

confidence: 99%

Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients

Holland-Bill¹,

Christiansen²,

Heide-Jørgensen³

et al. 2015

European Journal of Endocrinology

119

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Objective: We aimed to investigate the impact of hyponatremia severity on mortality risk and assess any evidence of a dose-response relation, utilizing prospectively collected data from population-based registries. Design: Cohort study of 279 508 first-time acute admissions to Departments of Internal Medicine in the North and Central Denmark Regions from 2006 to 2011. Methods: We used the Kaplan-Meier method (1 -survival function) to compute 30-day and 1-year mortality in patients with normonatremia and categories of increasing hyponatremia severity. Relative risks (RRs) with 95% CIs, adjusted for age, gender and previous morbidities, and stratified by clinical subgroups were estimated by the pseudo-value approach. The probability of death was estimated treating serum sodium as a continuous variable. Results: The prevalence of admission hyponatremia was 15% (41 803 patients). Thirty-day mortality was 3.6% in normonatremic patients compared to 7.3, 10.0, 10.4 and 9.6% in patients with serum sodium levels of 130-134.9, 125-129.9, 120-124.9 and !120 mmol/l, resulting in adjusted RRs of 1.4 (95% CI: 1.3-1.4), 1.7 (95% CI: 1.6-1.8), 1.7 (95% CI: 1.4-1.9) and 1.3 (95% CI: 1.1-1.5) respectively. Mortality risk was increased across virtually all clinical subgroups, and remained increased by 30-40% 1 year after admission. The probability of death increased when serum sodium decreased from 139 to 132 mmol/l. No clear increase in mortality was observed for lower concentrations. Conclusions: Hyponatremia is highly prevalent among patients admitted to Departments of Internal Medicine and is associated with increased 30-day and 1-year mortality risk, regardless of underlying disease. This risk seems independent of hyponatremia severity.

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Validation of the Charlson Comorbidity Index in Acutely Hospitalized Elderly Adults: A Prospective Cohort Study

Abstract: The CCI independently predicts short- and long-term mortality in acutely ill hospitalized elderly adults.

Cited by 261 publications

References 27 publications

Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

Hyponatremia and mortality risk: a Danish cohort study of 279 508 acutely hospitalized patients

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