Open Access

Age‑adjusted Charlson comorbidity index and in‑hospital mortality in critically ill patients with cardiogenic shock: A retrospective cohort study

  • Authors:
    • Dongmei Wei
    • Yang Sun
    • Rongtao Chen
    • Yuanting Meng
    • Wei Wu
  • View Affiliations

  • Published online on: May 5, 2023     https://doi.org/10.3892/etm.2023.11998
  • Article Number: 299
  • Copyright: © Wei et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Evidence regarding the relationship between age‑adjusted Charlson comorbidity index (ACCI) and in‑hospital mortality is limited. Therefore, the present study investigated whether there was an independent association between ACCI and in‑hospital mortality in critically ill patients with cardiogenic shock (CS) after adjusting for other covariates (age, sex, history of disease, scoring system, in‑hospital management, vital signs at presentation, laboratory findings and vasopressors). ACCI, calculated retrospectively after hospitalization between 2008 and 2019, was derived from intensive care unit (ICU) admissions at the Beth Israel Deaconess Medical Center (Boston, MA, USA). Patients with CS were classified into two categories based on predefined ACCI scores (low, <8; high, ≥8). Based on baseline ACCI, the risk of in‑hospital mortality in patients with CS was calculated using a multivariate Cox proportional risk model, and the threshold effect was calculated using a two‑piece linear regression model. The in‑hospital mortality rate was ~1.5 times greater in the ACCI high group compared with that in the ACCI low group [hazard ratio (HR)=1.45; 95% confidence interval (CI), 1.14‑1.86]. Additional analysis showed that ACCI had a curvilinear association with in‑hospital mortality risk in patients with CS, with a saturation effect predicted at 4.5. When ACCI was >4.5, the risk of in‑hospital CS death increased significantly with increasing ACCI (HR=1.122; 95% CI, 1.054‑1.194). Overall, ACCI was an independent predictor of in‑hospital mortality in ICU patients with CS. A non‑linear relationship was revealed between ACCI and in‑hospital mortality, where in‑hospital mortality increased significantly when ACCI was >4.5.
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June-2023
Volume 25 Issue 6

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Spandidos Publications style
Wei D, Sun Y, Chen R, Meng Y and Wu W: Age‑adjusted Charlson comorbidity index and in‑hospital mortality in critically ill patients with cardiogenic shock: A retrospective cohort study. Exp Ther Med 25: 299, 2023
APA
Wei, D., Sun, Y., Chen, R., Meng, Y., & Wu, W. (2023). Age‑adjusted Charlson comorbidity index and in‑hospital mortality in critically ill patients with cardiogenic shock: A retrospective cohort study. Experimental and Therapeutic Medicine, 25, 299. https://doi.org/10.3892/etm.2023.11998
MLA
Wei, D., Sun, Y., Chen, R., Meng, Y., Wu, W."Age‑adjusted Charlson comorbidity index and in‑hospital mortality in critically ill patients with cardiogenic shock: A retrospective cohort study". Experimental and Therapeutic Medicine 25.6 (2023): 299.
Chicago
Wei, D., Sun, Y., Chen, R., Meng, Y., Wu, W."Age‑adjusted Charlson comorbidity index and in‑hospital mortality in critically ill patients with cardiogenic shock: A retrospective cohort study". Experimental and Therapeutic Medicine 25, no. 6 (2023): 299. https://doi.org/10.3892/etm.2023.11998