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. 2023 Jan 26;23(1):7.
doi: 10.1186/s12873-022-00769-4.

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

Nan Zhang #  1 , Qingting Lin #  1 , Hui Jiang  1 , Huadong Zhu  2
Affiliations

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

Nan Zhang et al. BMC Emerg Med. .

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.

Keywords: Age-adjusted Charlson Comorbidity Index; Cardiac arrest; In-hospital mortality; Length of hospital stay.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The inclusion and exclusion criteria to select the final study cohort
Fig. 2
Fig. 2
The ROC curve for logistic regression analysis
Fig. 3
Fig. 3
The nomogram to predict the death risk of patients with cardiac arrest ICD-I462: whether the patient is with cardiac arrest due to underlying cardiac condition; BMI: body mass index; DBP: diastolic blood pressure; HR: heart rate; T: Temperature; SpO2: pulse oxygen saturation; GCS: Glasgow Coma Scale; Lac: lactate; AIDS: Acquired Immune Deficiency Syndrome; CCI: Charlson comorbidity index; MV: mechanical ventilation
See this image and copyright information in PMC

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