Boogaarts Hieronymus D, Conde Mariana P Duarte, Janssen Edith, van Nuenen Willemijn F M, de Vries Joost, Donders Rogier, Westert Gert P, Grotenhuis J André, Bartels Ronald H M A
Department of Neurosurgery, Radboudumc, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands,
Acta Neurochir (Wien). 2014 Sep;156(9):1663-7. doi: 10.1007/s00701-014-2160-3. Epub 2014 Jun 28.
Several studies have included different co-morbid conditions in prediction models for stroke patients. For subarachnoid haemorrhage (SAH), it is not known whether the Charlson Co-morbidity Index (CCI) is associated with outcome. We evaluated if this index was associated with outcome in patients with ruptured intracerebral aneurysms.
The data of all consecutive aneurysmal SAH (aSAH) patients treated at the Radboudumc, Nijmegen, The Netherlands and entered in the database were retrospectively analysed. Clinical condition at admission was recorded using the WFNS (World Federation of Neurological Surgeons Grading System) grade was collected, as were the age and treatment modality. The burden of co-morbidity was retrospectively registered using the CCI. Outcome was dichotomised on the modified Rankin Scale (mRS; 0-2, favourable outcome; 3-6, unfavourable outcome). A binary logistic regression analysis was performed.
Between 6th May 2008 and 31st July 2013, 457 patients were admitted because of non-traumatic SAH (aSAH). Seventy-seven (16.8 %) patients had no aneurysm. Of the 380 patients with aSAH, information on co-morbid conditions was available for 371 patients. Thirty-six of those 371 had no treatment because of: bad clinical condition in 34 (9.2 %), a non-treatable dissecting aneurysm in 1 (0.3 %) and the explicit wishes of another. Co-morbidity was present in 113 (31.5 %) patients. Binary logistic regression analysis revealed no added value of using the CCI in predicting the outcome (p = 0.91).
This study reports that the CCI is not associated with the outcome classified on the mRS at 6 months in patients after aSAH. The CCI has no added value in case-mix correction.
多项研究在中风患者预测模型中纳入了不同的共病情况。对于蛛网膜下腔出血（SAH），尚不清楚查尔森共病指数（CCI）是否与预后相关。我们评估了该指数与颅内动脉瘤破裂患者预后的相关性。
对荷兰奈梅亨拉德堡大学医学中心收治并录入数据库的所有连续性动脉瘤性SAH（aSAH）患者的数据进行回顾性分析。采用世界神经外科医师联盟（WFNS）分级系统记录入院时的临床状况，收集年龄和治疗方式。使用CCI对共病负担进行回顾性登记。预后根据改良Rankin量表（mRS；0 - 2为良好预后；3 - 6为不良预后）进行二分法分类。进行二元逻辑回归分析。
在2008年5月6日至2013年7月31日期间，457例患者因非创伤性SAH（aSAH）入院。77例（16.8%）患者无动脉瘤。在380例aSAH患者中，371例患者有共病情况信息。这371例患者中有36例未接受治疗，原因如下：3444例（9.2%）临床状况差，1例（0.3%）为不可治疗的夹层动脉瘤，1例因其他明确意愿。113例（31.5%）患者存在共病。二元逻辑回归分析显示，使用CCI预测预后无附加价值（p = 0.91）。
本研究报告称，CCI与aSAH患者6个月时mRS分类的预后无关。CCI在病例组合校正中无附加价值。
