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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Method
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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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Validation of a combined comorbidity index

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