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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2023

Open Access 01-12-2023 | Research

Age-adjusted Charlson Comorbidity Index as effective predictor for in-hospital mortality of patients with cardiac arrest: a retrospective study

Authors: Nan Zhang, Qingting Lin, Hui Jiang, Huadong Zhu

Published in: BMC Emergency Medicine | Issue 1/2023

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Abstract

Background

Cardiac arrest is currently one of the leading causes of mortality in clinical practice, and the Charlson Comorbidity Index (CCI) is widely utilized to assess the severity of comorbidities. We aimed to evaluate the relationship between the age-adjusted CCI score and in-hospital mortality in intensive care unit (ICU) patients with the diagnosis of cardiac arrest, which is important but less explored previously.

Methods

This was a retrospective study including patients aged over 18 years from the MIMIC-IV database. We calculated the age-adjusted CCI using age information and ICD codes. The univariate analysis for varied predictors’ differences between the survival and the non-survival groups was performed. In addition, a multiple factor analysis was conducted based on logistic regression analysis with the primary result set as hospitalization death. An additional multivariate regression analysis was conducted to estimate the influence of hospital and ICU stay.

Results

A total of 1772 patients were included in our study, with median age of 66, among which 705 (39.8%) were female. Amongst these patients, 963 (54.3%) died during the hospitalization period. Patients with higher age-adjusted CCI scores had a higher likelihood of dying during hospitalization (P < 0.001; OR: 1.109; 95% CI: 1.068–1.151). With the age-adjusted CCI incorporated into the predictive model, the area under the receiver operating characteristic curve was 0.794 (CI: 0.773–0.814), showing that the prediction model is effective. Additionally, patients with higher age-adjusted CCI scores stayed longer in the hospital (P = 0.026, 95% CI: 0.056–0.896), but there was no significant difference between patients with varied age-adjusted CCI scores on the days of ICU stay.

Conclusion

The age-adjusted CCI is a valid indicator to predict death in ICU patients with cardiac arrest, which can offer enlightenment for both theory literatures and clinical practice.
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Metadata
Title
Age-adjusted Charlson Comorbidity Index as effective predictor for in-hospital mortality of patients with cardiac arrest: a retrospective study
Authors
Nan Zhang
Qingting Lin
Hui Jiang
Huadong Zhu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2023
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-022-00769-4

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