The Charlson Comorbidity and Barthel Index predict length of hospital stay, mortality, cardiovascular mortality and rehospitalization in unselected older patients admitted to the emergency department.
Activities of Daily Living
Aged
Aged, 80 and over
Cardiovascular Diseases
/ mortality
Comorbidity
Emergency Service, Hospital
/ statistics & numerical data
Female
Geriatric Assessment
/ statistics & numerical data
Hospital Mortality
Humans
Kaplan-Meier Estimate
Length of Stay
/ economics
Male
Middle Aged
Multivariate Analysis
Patient Readmission
/ economics
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Activities of daily living
Aged
Decision support techniques
Emergency department
Geriatric assessment/methods
Hospital mortality
Kaplan–Meier estimate
Predictive value of tests
Prognosis
Proportional hazards models: prospective studies
Risk assessment
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
05
08
2018
accepted:
01
11
2018
pubmed:
9
11
2018
medline:
24
10
2019
entrez:
9
11
2018
Statut:
ppublish
Résumé
The Charlson Comorbidity Index (CCI) is the most widely used assessment tool to report the presence of comorbid conditions. The Barthel index (BI) is used to measure performance in activities of daily living. We prospectively investigated the performance of CCI or BI to predict length of hospital stay (LOS), mortality, cardiovascular (CV) mortality and rehospitalization in unselected older patients on admission to the emergency department (ED). We also studied the association of CCI or BI with costs. We consecutively enrolled 307 non-surgical patients ≥ 68 years presenting to the ED with a wide range of comorbid conditions. Baseline characteristic, clinical presentation, laboratory data, echocardiographic parameters and hospital costs were compared among patients. All patients were followed up for mortality, CV mortality and rehospitalization within the following 12 months. A multivariate analysis was performed. Mortality was increased for patients having a higher CCI or BI with a hazard ratio around 1.17-1.26 or 0.75-0.81 (obtained for different models) for one or ten point increase in CCI or BI, respectively. The prognostic impact of a high CCI or BI on CV mortality and rehospitalization was also significant. In a multiple linear regression using the same independent variables, CCI and BI were identified as a predictor of LOS in days. Multiple linear regression analysis did not confirm an association between CCI and costs, but for BI after adjusting for multiple factors. CCI and BI independently predict LOS, mortality, CV mortality, and rehospitalization in unselected older patients admitted to ED.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
The Charlson Comorbidity Index (CCI) is the most widely used assessment tool to report the presence of comorbid conditions. The Barthel index (BI) is used to measure performance in activities of daily living. We prospectively investigated the performance of CCI or BI to predict length of hospital stay (LOS), mortality, cardiovascular (CV) mortality and rehospitalization in unselected older patients on admission to the emergency department (ED). We also studied the association of CCI or BI with costs.
METHODS
METHODS
We consecutively enrolled 307 non-surgical patients ≥ 68 years presenting to the ED with a wide range of comorbid conditions. Baseline characteristic, clinical presentation, laboratory data, echocardiographic parameters and hospital costs were compared among patients. All patients were followed up for mortality, CV mortality and rehospitalization within the following 12 months. A multivariate analysis was performed.
RESULTS
RESULTS
Mortality was increased for patients having a higher CCI or BI with a hazard ratio around 1.17-1.26 or 0.75-0.81 (obtained for different models) for one or ten point increase in CCI or BI, respectively. The prognostic impact of a high CCI or BI on CV mortality and rehospitalization was also significant. In a multiple linear regression using the same independent variables, CCI and BI were identified as a predictor of LOS in days. Multiple linear regression analysis did not confirm an association between CCI and costs, but for BI after adjusting for multiple factors.
CONCLUSION
CONCLUSIONS
CCI and BI independently predict LOS, mortality, CV mortality, and rehospitalization in unselected older patients admitted to ED.
Identifiants
pubmed: 30406920
doi: 10.1007/s40520-018-1067-x
pii: 10.1007/s40520-018-1067-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1233-1242Subventions
Organisme : Robert-Bosch-Stiftung
ID : 32.5.1141.0036.0