Zavascki Alexandre Prehn, Fuchs Sandra Costa
Medical Sciences Post-graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
J Clin Epidemiol. 2007 Sep;60(9):867-8. doi: 10.1016/j.jclinepi.2006.11.004. Epub 2007 Mar 23.
To discuss the need for reappraisal of AIDS score weight of the Charlson comorbidity index.
This article is a comment on Charlson comorbidity index.
This article shows that the weight assigned for AIDS in the original cohort of Charlson score may be higher considering the dramatic improvement in the prognosis of such patients after the advent of highly active antiretroviral therapy. Only a few exceptions among HIV-related diseases are still strongly associated with high mortality rates within 1 year. This might lead to an inaccurate measurement of the impact of Charlson score on mortality rate, particularly in cohorts with high relative number of AIDS patients.
Charlson comorbidity index should be reassessed in cohorts with higher proportions of AIDS patients, taking into account the current prognosis of the disease. A stratification of AIDS-related category may be required to improve Charlson score accuracy in predicting mortality or adjusting for confounding.
探讨重新评估查尔森合并症指数中艾滋病评分权重的必要性。
本文是对查尔森合并症指数的评论。
本文表明，考虑到高效抗逆转录病毒疗法出现后此类患者预后的显著改善，查尔森评分原始队列中赋予艾滋病的权重可能过高。在与艾滋病毒相关的疾病中，只有少数例外情况仍与1年内的高死亡率密切相关。这可能导致对查尔森评分对死亡率影响的测量不准确，尤其是在艾滋病患者相对数量较高的队列中。
在艾滋病患者比例较高的队列中，应重新评估查尔森合并症指数，同时考虑到该疾病的当前预后。可能需要对艾滋病相关类别进行分层，以提高查尔森评分在预测死亡率或调整混杂因素方面的准确性。
