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Observational Study
. 2024 Nov 1;103(44):e40033.
doi: 10.1097/MD.0000000000040033.

Role of Charlson comorbidity index in predicting intensive care unit readmission in patients with aortic aneurysm

Yu-Fei Zhan  1 , Feng Li  1 , Long-Chuan Wu  1 , Lin Chen  1 , Can-Yan Zhu  1 , Ming-Shuai Han  1 , Guo-Fang Ma  1 , Yong-Hong Zhong  2
Affiliations
Observational Study

Role of Charlson comorbidity index in predicting intensive care unit readmission in patients with aortic aneurysm

Yu-Fei Zhan et al. Medicine (Baltimore). .

Abstract

The purpose of this study was to investigate the value of the Charlson comorbidity index (CCI) in predicting intensive care unit (ICU) readmission in aortic aneurysm (AA) patients. Patient information came from the Medical Information Mart for Intensive Care- IV (MIMIC-IV) database. The relationship between CCI and ICU readmission was analyzed by restricted cubic spline, generalized linear regression, trend analysis, and hierarchical analysis. The clinical value of CCI in predicting ICU readmission was analyzed by receiver operating characteristic curve, decision curve analysis, XGBoost regression, and random forest regression. A total of 523 patients with AA were enrolled in the study. Patients with AA who were readmitted to the ICU had higher width of red blood cell distribution width (RDW) and higher CCI. CCI had better performance and clinical net benefit for predicting ICU readmission than RDW. An independent nonlinear relationship was found between CCI and ICU readmission. The trend analysis suggested that the risk of ICU readmission increased with higher CCI scores. The hierarchical analysis showed that their association was mainly found in surgery requirement populations regardless of AA types. Further, CCI was found to have better clinical value in predicting ICU readmission of thoracic aortic aneurysm (TAA) patients undergoing surgery. Age, renal disease, chronic lung disease, and dementia were important components of CCI in predicting ICU readmission of TAA patients undergoing surgery. CCI was independently associated with the ICU readmission of AA patients in a positive relationship and had more favorable prediction performance in TAA patients who underwent surgery.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Clinical value of CCI in predicting intensive care unit (ICU) readmission and their association exploration (A) the receiver operating characteristic (ROC) curve, (B) the decision curve analysis (DCA) curve, (C) the RCS analysis. RDE = red blood cell distribution width, CCI = Charlson comorbidity index, SOFA = sequential organ failure assessment,. Model 1: RDW, Model 2: CCI, Model 3: SOFA score at 24 hours.
Figure 2.
Figure 2.
Clinical value of CCI in thoracic aortic aneurysm who underwent surgery (A) the ROC curve, (B) the DCA curve.
Figure 3.
Figure 3.
The importance ranking of and the ROC curve for the CCI component in predicting ICU readmission (A) the XGBoost regression, (B) the random forest regression, (C) the ROC curve.
See this image and copyright information in PMC

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