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Charlson 共病指数预测老年女性心血管疾病患者重复住院和死亡的风险。

Charlson Comorbidity Index as a predictor of repeated hospital admission and mortality among older women diagnosed with cardiovascular disease.

机构信息

Research Centre for Generational Health and Ageing (RCGHA), Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.

Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, 2308, Australia.

出版信息

Aging Clin Exp Res. 2021 Oct;33(10):2873-2878. doi: 10.1007/s40520-021-01805-2. Epub 2021 Feb 16.

Abstract

BACKGROUND

Comorbidity can complicate cardiovascular diseases (CVDs), increasing the risk of adverse events including hospitalisation and death. This study aimed to assess the Charlson Comorbidity Index (CCI) as a predictor of repeated hospital admission and mortality in older CVD patients.

METHODS

This study linked data from the Australian longitudinal study on women's health (ALSWH) with hospital and National Death Index datasets to identify dates for hospital admission, discharge, and death for women born 1921-26. CCI was calculated using the International Statistical Classification of Diseases, Australia Modification (ICD-10-AM) diagnostic codes.

RESULTS

Women with a higher CCI on index admission had increased risk of repeated hospital admission (AHR = 1.29, 95% CI 1.06, 1.58) and mortality (AHR = 3.05, 95% CI 2.15, 4.31). Older age and hypertension were also significantly associated with a higher risk of repeated hospital admission and mortality. Living in a remote area was associated with a higher risk of mortality.

CONCLUSIONS

The Charlson Comorbidity Index predicts repeated hospital admission and mortality incidences among older women with CVD. Improving management of comorbidities for older CVD patients should be considered as part of a strategy to mitigate subsequent repeated hospitalisation and delay mortality.

摘要

背景

合并症会使心血管疾病(CVD)变得复杂,增加包括住院和死亡在内的不良事件的风险。本研究旨在评估 Charlson 合并症指数(CCI)作为预测老年 CVD 患者再次住院和死亡的指标。

方法

本研究将澳大利亚女性健康纵向研究(ALSWH)的数据与医院和国家死亡指数数据集相链接,以确定出生于 1921-26 年的女性的住院、出院和死亡日期。CCI 是使用国际疾病分类标准,澳大利亚修订版(ICD-10-AM)诊断代码计算的。

结果

指数入院时 CCI 较高的女性再次住院的风险增加(AHR=1.29,95%CI 1.06,1.58)和死亡率(AHR=3.05,95%CI 2.15,4.31)。年龄较大和高血压也与再次住院和死亡的风险增加显著相关。居住在偏远地区与死亡率升高相关。

结论

Charlson 合并症指数预测了老年 CVD 女性再次住院和死亡率的发生率。应考虑改善老年 CVD 患者合并症的管理,作为减轻随后再次住院和延迟死亡的策略的一部分。

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