Validation of the Charlson Comorbidity Index in acutely hospitalized elderly adults: a prospective cohort study

J Am Geriatr Soc. 2014 Feb;62(2):342-6. doi: 10.1111/jgs.12635. Epub 2014 Jan 21.

Abstract

Objectives: To determine whether the Charlson Comorbidity Index (CCI) predicts short- and long-term mortality.

Design: Prospective cohort study.

Setting: The medical department of two university hospitals and one community-based hospital.

Participants: Acutely hospitalized individuals aged 65 and older with a mean age of 77.8 ± 7.9, 45.8% male (n = 1,313).

Measurements: In eligible persons, information on demographic characteristics, activities of daily living (modified Katz ADL Index score), and disease-related measures was collected within 48 hours after admission. Follow-up using self-reporting questionnaires was performed at 3 months and 1 year. Functional decline was defined as a decline of at least 1 point on the modified Katz ADL Index score at 12 months from baseline. Mortality data at 3 months and 1 and 5 years were collected from the municipal database.

Results: Logistic regression analysis, adjusted for age and sex, showed that participants with a CCI of 5 or more had higher 3-month (odds ratio (OR) = 3.6, 95% confidence interval (CI) = 2.1-6.4), 1-year (OR = 7.1, 95% CI = 4.2-11.9), and 5-year (OR = 52.4, 95% CI = 13.3-206.4) mortality than those with a CCI of 0. Participants with CCI scores between 1 and 4 also had greater mortality risk at 3 months and 1 and 5 years.

Conclusion: The CCI independently predicts short- and long-term mortality in acutely ill hospitalized elderly adults.

Keywords: Charlson Comorbidity Index; hospital; mortality risk.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Activities of Daily Living*
  • Acute Disease / epidemiology
  • Aged
  • Comorbidity
  • Confidence Intervals
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Netherlands / epidemiology
  • Odds Ratio
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Risk Assessment / methods*
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Survival Rate / trends
  • Time Factors