Cited by 6,587Cardiac, Anesthesia and Surgical OutcomesChronic Disease Management StrategiesFrailty in Older Adults

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Validation of a combined comorbidity index

Charlson, Mary, Szatrowski, Ted P., Peterson, Janey, Gold, Jeffrey·1994·Journal of Clinical Epidemiology

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Abstract

The basic objective of this paper is to evaluate an age-comorbidity index in a cohort of patients who were originally enrolled in a prospective study to identify risk factors for peri-operative complications. Two-hundred and twenty-six patients were enrolled in the study. The participants were patients with hypertension or diabetes who underwent elective surgery between 1982 and 1985 and who survived to discharge. Two-hundred and eighteen patients survived until discharge. These patients were followed for at least five years post-operatively. The estimated relative risk of death for each comorbidity rank was 1.4 and for each decade of age was 1.4. When age and comorbidity were modelled as a combined age-comorbidity score, the estimated relative risk for each combined age-comorbidity unit was 1.45. Thus, the estimated relative risk of death from an increase of one in the comorbidity score proved approximately equal to that from an additional decade of age. The combined age-comorbidity score may be useful in some longitudinal studies to estimate relative risk of death from prognostic clinical covariates.

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Post-operative atrial fibrillation and risk of heart failure hospitalization
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“Fourth, we additionally adjusted our primary model for Charlson comorbid conditions.(12) Fifth, we examined the association between POAF and HF hospitalization after adjustment for the CHA2DS2-VASc score instead of our primary model covariates.”
Method
Statin initiation and risk of incident kidney disease in patients with diabetes
Zhou, S., Su, L., Xu, R., Li, Y., Chen, R., Cao, Y., Gao, P., Zhang, X., Luo, F., Gao, Q., et al. (2023) · Canadian Medical Association Journal · doi:10.1503/cmaj.230093 · Cited by 52
A little slower, but just as good: postgraduate year resident versus attending outcomes in laparoscopic ventral hernia repair
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Holst, M., Yifter‐Lindgren, E., Surowiak, M., Nielsen, K. R., Mowé, M., Carlsson, M., Jacobsen, B. A., Cederholm, T., Fenger‐Grøn, M., & Rasmussen, H. H. (2012) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12010 · Cited by 52
Revision surgery for lumbar pseudarthrosis
Dede, Ö., Thuillier, D. U., Pekmezci, M., Ames, C. P., Hu, S. S., Berven, S., & Deviren, V. (2013) · The Spine Journal · doi:10.1016/j.spinee.2013.05.039 · Cited by 52
Multicenter Prospective Observational Study of the Comparative Efficacy and Safety of Vancomycin versus Teicoplanin in Patients with Health Care-Associated Methicillin-Resistant Staphylococcus aureus Bacteremia
Yoon, Y. K., Park, D. W., Sohn, J. W., Kim, H. Y., Ys, K., Lee, C., Lee, M. S., Ryu, S. Y., Jang, H., Choi, Y. J., et al. (2013) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00520-13 · Cited by 52
Burden of Comorbid Medical Conditions and Quality of Diabetes Care
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“We compared AutoPrognosis to two benchmarks that are widely used in clinical research and Epidemiology: the Cox proportional hazard model (Cox 1972) and the Charlson comorbidity index (Charlson et al. 1994).”
Method
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A practical approach to the older patient with cancer
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Validation of GLIM malnutrition criteria in cancer patients undergoing major abdominal surgery: A large-scale prospective study
Tan, S., Wang, J., Zhou, F., Tang, M., Xu, J., Zhang, Y., Yan, M., Li, S., Zhang, Z., & Wu, G. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.010 · Cited by 57
High Mortality After Total Knee Arthroplasty Periprosthetic Joint Infection is Related to Preoperative Morbidity and the Disease Process but Not Treatment
Drain, N. P., Bertolini, D. M., Anthony, A., Feroze, M. W., Chao, R., Onyekweli, T., Longo, S., Hersh, B. L., Smith, C., Rothenberger, S. D., et al. (2022) · The Journal of Arthroplasty · doi:10.1016/j.arth.2022.03.046 · Cited by 51
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Authors: Charlson, M., Szatrowski, T. P., Peterson, J., & Gold, J.
Affiliations: Hospital for Special Surgery (US)
Cornell University (US)
ORCID: Charlson, Mary
Venue: Journal of Clinical Epidemiology
Publisher: Elsevier BV
Published: 1994-11
Volume: 47
Issue: 11
Pages: 1245-1251
ISSN: 0895-4356 (ISSN-L)
DOI: 10.1016/0895-4356(94)90129-5
OpenAlex: W2154692607
Cited by: 6,587
References: 5
Citations by year: 2026: 263 · 2025: 344 · 2024: 417 · 2023: 468 · 2022: 569 · 2021: 671 · 2020: 593 · 2019: 477 · 2018: 448 · 2017: 365 · 2016: 303 · 2015: 288 · 2014: 255 · 2013: 212 · 2012: 166
FWCI: 3.14
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Clinical Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (R23 HL27613)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (IP60AR38520-01A1)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords: comorbidity index, mortality risk, hypertension, diabetes mellitus, elective surgery, perioperative complications, relative risk, prognostic score validation, postoperative survival
MeSH terms: Age Factors, Humans, Models, Theoretical, Mortality, Prognosis, Risk, Reproducibility of Results, Cohort Studies, Comorbidity, Proportional Hazards Models, Survival Analysis

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