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Validation of a combined comorbidity index
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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“Scores of the Charlson comorbidity index (CCI) were applied to adjust baseline confounding factors weighted according to the mortality risk [37].”
From Risk analysis of use of different classes of antidepressants on subsequent dementia: A nationwide cohort study in Taiwan (2017) · cites this paper as [37]
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Romero, M. M., Céspedes, A. A., Sahuquillo, M. T. T., Zamora, E. B. C., Ballesteros, C. G., Alfaro, V. S., Bru, R. L., López-Utiel, M., Cifuentes, S. C., Peña-Longobardo, L. M., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0241030 · Cited by 90
“Mini Nutritional Assessment Short Form (MNA-SF) [20] were assessed, and comorbidity was determined with the Charlson index [21].”
MethodDepression and anxiety in colorectal cancer patients: Ties to pain, fatigue, and inflammation
Renna, M. E., Shrout, M. R., Madison, A. A., Alfano, C. M., Povoski, S. P., Lipari, A. M., Carson, W. E., Malarkey, W. B., & Kiecolt‐Glaser, J. K. (2022) · Psycho-Oncology · doi:10.1002/pon.5986 · Cited by 92
“The Charlson comorbidity index provided data on physical comorbidities.(37) The Charlson, originally designed for cancer patients, assigns weights to 19 medical conditions with higher scores representing more physical comorbidities.”
MethodGarrido, M. M., Harrington, S., & Prigerson, H. G. (2014) · Cancer · doi:10.1002/cncr.28970 · Cited by 90
Lanspa, M. J., Dickerson, J., Morris, A. H., Orme, J. F., Holmen, J. R., & Hirshberg, E. L. (2014) · Critical Care · doi:10.1186/cc13851 · Cited by 91
Maringe, C., Fowler, H., Rachet, B., & Luque-Fernández, M. Á. (2017) · PLoS ONE · doi:10.1371/journal.pone.0172814 · Cited by 90
Wang, Z., Jiang, W., Chen, X., Yang, L., Wang, H., & Liu, Y. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02102-3 · Cited by 89
“The presence of comorbidity was evaluated using Charlson comorbidity index (CCI) score, which comprises 17 comorbid conditions and assigned a weigh of 1 to 6 points according to its impact on mortality [29].”
MethodColey, R. Y., Johnson, E., Simon, G. E., Cruz, M., & Shortreed, S. M. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0493 · Cited by 100
Blevins, M. L., Weeks, H. L., Pisansky, A. J. B., Yong, R., & Stringer, E. A. (2019) · Pain Medicine · doi:10.1093/pm/pnz083 · Cited by 88
Haro, G. J., Sheu, B., Marcus, S. G., Sarin, A., Campbell, L., Jablons, D. M., & Kratz, J. R. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000003719 · Cited by 88
Islim, A. I., Kolamunnage‐Dona, R., Mohan, M., Moon, R. D. C., Crofton, A., Haylock, B. J., Rathi, N., Brodbelt, A. R., Mills, S. J., & Jenkinson, M. D. (2019) · Neuro-Oncology · doi:10.1093/neuonc/noz160 · Cited by 88
The characterisation and determinants of quality of life in ANCA associated vasculitis
Basu, N., McClean, A., Harper, L., Amft, E. N., Dhaun, N., Luqmani, R. A., Little, M. A., Jayne, D. R. W., Floßmann, O., McLaren, J., et al. (2013) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2012-202750 · Cited by 89
Bosch, X., Monclús, E., Escoda, O., Guerra-García, M., Moreno, P., Guasch, N., & López‐Soto, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175125 · Cited by 88
Effect of chronic urticaria on US patients: analysis of the National Health and Wellness Survey
Vietri, J., Turner, S. J., Tian, H., Isherwood, G., Balp, M., & Gabriel, S. (2015) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2015.06.030 · Cited by 87
Fox, K. M., Tai, M., Kostev, K., Hatz, M., Qian, Y., & Laufs, U. (2017) · Clinical Research in Cardiology · doi:10.1007/s00392-017-1193-z · Cited by 89
Implementation of Transcatheter Aortic Valve Replacement in France
Nguyen, V., Michel, M., Eltchaninoff, H., Gilard, M., Dindorf, C., Iung, B., Mossialos, E. A., Cribier, A. G., Vahanian, A. S., Chevreul, K., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.01.079 · Cited by 87
Risk Factors Associated With Medication Errors Among Patients Suffering From Chronic Disorders
Rasool, M. F., Rehman, A. U., Imran, I., Abbas, S., Shah, S., Abbas, G., Khan, I., Shakeel, S., Hassali, M. A., & Hayat, K. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.531038 · Cited by 87
“The comorbidities were scored using the CCI scale (31).”
Method
Metadata
- 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)
- 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
- 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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