Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
Institute of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
BMC Cardiovasc Disord. 2023 Mar 6;23(1):111. doi: 10.1186/s12872-023-03151-9.
Charlson Comorbidity Index (CCI) is positively associated with all-cause readmission in patients with heart failure (HF) in western countries. However, there is a scarcity of strong scientific evidence supporting the correlation in China. This study aimed at testing this hypothesis in Chinese. METHODS: We conducted a secondary analysis of 1,946 patients with HF in Zigong Fourth People's Hospital in China between December 2016 to June 2019. Logistic regression models were used to study the hypotheses, with adjustments for the four regression models. We also explore the linear trend and possible nonlinear relationship between CCI and readmission within six months. We further conducted subgroup analysis and tests for interaction to examine the possible interaction between CCI and the endpoint. Additionally, CCI alone and several combinations of variables based on CCI were used to predict the endpoint. Under the curve (AUC), sensitivity and specificity were reported to evaluate the performance of the predicted model.
In the adjusted II model, CCI was an independent prognostic factor for readmission within six months in patients with HF (OR = 1.14, 95% CI: 1.03-1.26, P = 0.011). Trend tests revealed that there was a significant linear trend for the association. A nonlinear association was identified between them and the inflection point of CCI was 1. Subgroup analyses and tests for interaction indicated that cystatin played an interactive role in the association. ROC analysis indicated neither CCI alone nor combinations of variables based on CCI were adequate for prediction.
CCI was independently positively correlated with readmission within six months in patients with HF in Chinese population. However, CCI has limited value on predicting readmission within six months in patients with HF.
在西方国家，Charlson 合并症指数（CCI）与心力衰竭（HF）患者的全因再入院呈正相关。然而，中国缺乏强有力的科学证据支持这一相关性。本研究旨在检验这一假说在中国人群中的相关性。
我们对中国自贡市第四人民医院 2016 年 12 月至 2019 年 6 月期间的 1946 例 HF 患者进行了二次分析。使用逻辑回归模型研究假设，并对四个回归模型进行了调整。我们还探索了 CCI 与 6 个月内再入院之间的线性趋势和可能的非线性关系。我们进一步进行了亚组分析和交互作用检验，以检验 CCI 与终点之间可能的交互作用。此外，还单独使用 CCI 及其基于 CCI 的变量的几种组合来预测终点。报告曲线下面积（AUC）、敏感性和特异性，以评估预测模型的性能。
在调整后的 II 模型中，CCI 是 HF 患者 6 个月内再入院的独立预后因素（OR=1.14，95%CI：1.03-1.26，P=0.011）。趋势检验显示，两者之间存在显著的线性趋势。两者之间存在非线性关联，CCI 的拐点为 1。亚组分析和交互作用检验表明胱抑素在两者之间具有交互作用。ROC 分析表明，CCI 单独或基于 CCI 的变量组合均不能充分预测 6 个月内再入院。
CCI 与中国人群中 HF 患者 6 个月内再入院独立正相关。然而，CCI 对预测 HF 患者 6 个月内再入院的价值有限。
