Geriatrics Section, Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands.
J Am Geriatr Soc. 2014 Feb;62(2):342-6. doi: 10.1111/jgs.12635. Epub 2014 Jan 21.
To determine whether the Charlson Comorbidity Index (CCI) predicts short- and long-term mortality.
Prospective cohort study.
The medical department of two university hospitals and one community-based hospital.
Acutely hospitalized individuals aged 65 and older with a mean age of 77.8 ± 7.9, 45.8% male (n = 1,313).
In eligible persons, information on demographic characteristics, activities of daily living (modified Katz ADL Index score), and disease-related measures was collected within 48 hours after admission. Follow-up using self-reporting questionnaires was performed at 3 months and 1 year. Functional decline was defined as a decline of at least 1 point on the modified Katz ADL Index score at 12 months from baseline. Mortality data at 3 months and 1 and 5 years were collected from the municipal database.
Logistic regression analysis, adjusted for age and sex, showed that participants with a CCI of 5 or more had higher 3-month (odds ratio (OR) = 3.6, 95% confidence interval (CI) = 2.1-6.4), 1-year (OR = 7.1, 95% CI = 4.2-11.9), and 5-year (OR = 52.4, 95% CI = 13.3-206.4) mortality than those with a CCI of 0. Participants with CCI scores between 1 and 4 also had greater mortality risk at 3 months and 1 and 5 years.
The CCI independently predicts short- and long-term mortality in acutely ill hospitalized elderly adults.
确定 Charlson 合并症指数 (CCI) 是否预测短期和长期死亡率。
前瞻性队列研究。
两所大学医院和一所社区医院的医疗部门。
年龄在 65 岁及以上的急性住院患者,平均年龄为 77.8 ± 7.9 岁,45.8%为男性(n = 1313)。
在符合条件的人群中,在入院后 48 小时内收集人口统计学特征、日常生活活动(改良 Katz ADL 指数评分)和疾病相关指标的信息。使用自我报告问卷进行 3 个月和 1 年的随访。功能下降定义为在基线后 12 个月改良 Katz ADL 指数评分至少下降 1 分。通过市数据库收集 3 个月、1 年和 5 年的死亡率数据。
调整年龄和性别后,逻辑回归分析显示,CCI 为 5 分或更高的参与者,3 个月(优势比 (OR) = 3.6,95%置信区间 (CI) = 2.1-6.4)、1 年(OR = 7.1,95% CI = 4.2-11.9)和 5 年(OR = 52.4,95% CI = 13.3-206.4)的死亡率更高,CCI 为 0 的参与者。CCI 评分在 1 至 4 分之间的参与者,3 个月和 1 年和 5 年的死亡率风险也更高。
CCI 独立预测急性住院老年患者的短期和长期死亡率。