Predictive Value of Charlson Comorbidity Index in Prognosis of Aged Chronic Obstructive Pulmonary Disease Patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZhangLin , PiChunmei ,  NieXiuhong

Department of Respiratory Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China;

Corresponding author：

NieXiuhong, Email: xiuhongnie@126.com

Keywords：

Charlson comorbidity index; Chronic obstructive pulmonary disease; Prognosis

DOI：

10.7507/1671-6205.2016079

Video：

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Objective To explore the predictive value of Charlson comorbidity index(CCI)in the prognosis of aged chronic obstructive pulmonary disease (COPD)patients. Methods A retrospective review was performed for 350 hospitalized aged COPD patients who admitted in Xuanwu Hospital of Capital Medical University from January 2010 to January 2015.The clinical data were recorded including age,body mass index (BMI),comorbidities (CCI score),FEV₁%pred,the times of acute exacerbation of COPD a year before admission,and in-hospital mortality.The risk factors of acute exacerbation and in-hospital mortality were analyzed by multivariable logistic regression. Results There were 177 patients who had experienced acute exacerbation more than 2 times per year and 173 patients who had experienced acute exacerbation less than 2 times per year.Multivariable logistic regression analysis showed that CCI [OR=1.559,95% CI(1.309,1.856),P=0.000] and FEV₁%pred [OR=0.979,95% CI(0.964,0.994),P=0.006] were the independent predictors for acute exacerbation of COPD.The in-hospital mortality rate was 10.3%(36/314). Multivariable logistic regression analysis showed that CCI [OR＝1.894,95% CI (1.422,2.523),P=0.000],age [OR=1.153,95% CI(1.063,1.251),P=0.001],FEV₁%pred [OR=0.916,95% CI(0.878,0.955),P=0.000],BMI [OR=0.849,95% CI(0.749,0.962),P=0.011],acute exacerbation more than 2 times per year [OR=6.340,95% CI(1.469,27.366),P=0.013] were the independent predictors for mortality. Conclusion CCI is an independent risk factor associated with in-hospital mortality and acute exacerbation of COPD.

Citation： ZhangLin, PiChunmei, NieXiuhong. Predictive Value of Charlson Comorbidity Index in Prognosis of Aged Chronic Obstructive Pulmonary Disease Patients. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(4): 333-336. doi: 10.7507/1671-6205.2016079 Copy

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1. 中华医学会呼吸病分会慢性阻塞性肺部疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志,2013,36:255-264.
2. 蔡柏蔷. 应重视慢性阻塞性肺疾病的合并症问题.中华结核和呼吸杂志,2013,36:245-247.
3. GOLD Executive Committee.Global Strategy for the diagnosis,management and prevention of chronic obstructive pulmonary disease (Revised 2011).[EB/OL][2015-09-16].http://www.goldcopd.org.
4. Charlson M,Pompei P,Ales K,et al.A new method of classifying prognostic comorbidity in longitudinal studies:development and validation.J Chronic Dis,1987,40:373-383.
5. 边士淇, 寿松涛,李望,等.查尔森合并症指数对脓毒症患者预后的评估价值.中国全科医学,2015,18:1637-1640.
6. Sachdev M,Sun JL,Tsiatis AA,et al.The prognostic importance of comorbidity for mortality in patients with stable coronary artery disease.J Am Coll Cardiol,2004,43:576-582.
7. Goldstein LB,Samsa GP,Matchar DB,et al.Charlson index comorbidity adjustment for ischemic stroke outcome studies.Stroke,2004,35:1941-1945.
8. Fried L,Bernardini J,Piraino B.Charlson comorbidity index as a predictor of outcomes in incident peritoneal dialysis patients.Am J Kidney Dis,2001,37:337-342.
9. Schneeweiss S,Wang PS,Avorn J,et al.Improved comorbidity adjustment for predicting mortality in Medicare populations.Health Serv Res,2003,38:1103-1120.
10. Groenewegen KH,Schols AM,Wouters EF.Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD.Chest,2003,124:459-467.
11. 漆波, 张鹤,李国智,等.慢性阻塞性肺疾病急性加重患者住院死亡影响因素研究.中国呼吸与危重监护杂志,2013,12:24-28.

Chinese Journal of Respiratory and Critical Care Medicine

Predictive Value of Charlson Comorbidity Index in Prognosis of Aged Chronic Obstructive Pulmonary Disease Patients

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