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Validation of a combined comorbidity index

  • Mary Charlson
    Correspondence
    All correspondence should be addressed to: Dr Mary Charlson, Cornell Medical College, 515 E. 71st Street, New York, NY 10021, U.S.A.
    Affiliations
    Clinical Epidemiology Unit, Department of Medicine, Cornell University Medical College, New York, NY 10021, U.S.A.

    Research Methodology Core, Cornell Arthritis and Musculoskeletal Disease Center, Hospital for Special Surgery, Cornell University Medical College, New York, NY 10021, U.S.A.
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  • Ted P. Szatrowski
    Affiliations
    Clinical Epidemiology Unit, Department of Medicine, Cornell University Medical College, New York, NY 10021, U.S.A.

    Research Methodology Core, Cornell Arthritis and Musculoskeletal Disease Center, Hospital for Special Surgery, Cornell University Medical College, New York, NY 10021, U.S.A.
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  • Janey Peterson
    Affiliations
    Clinical Epidemiology Unit, Department of Medicine, Cornell University Medical College, New York, NY 10021, U.S.A.

    Research Methodology Core, Cornell Arthritis and Musculoskeletal Disease Center, Hospital for Special Surgery, Cornell University Medical College, New York, NY 10021, U.S.A.
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  • Jeffrey Gold
    Affiliations
    Department of Surgery, Cornell University Medical College, New York, NY 10021, U.S.A.
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      Abstract

      The basic objective of this paper is to evaluate an age-comorbidity index in a cohort of patients who were originally enrolled in a prospective study to identify risk factors for peri-operative complications. Two-hundred and twenty-six patients were enrolled in the study. The participants were patients with hypertension or diabetes who underwent elective surgery between 1982 and 1985 and who survived to discharge. Two-hundred and eighteen patients survived until discharge. These patients were followed for at least five years post-operatively. The estimated relative risk of death for each comorbidity rank was 1.4 and for each decade of age was 1.4. When age and comorbidity were modelled as a combined age-comorbidity score, the estimated relative risk for each combined age-comorbidity unit was 1.45. Thus, the estimated relative risk of death from an increase of one in the comorbidity score proved approximately equal to that from an additional decade of age. The combined age-comorbidity score may be useful in some longitudinal studies to estimate relative risk of death from prognostic clinical covariates.

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      References

        • Charlson M.E.
        • Ales K.A.
        • Pompei P.
        • MacKenzie C.R.
        A new method of classification of prognostic comorbidity for longitudinal studies: development and validation.
        J Chron Disease. 1987; 40: 373-383
        • Hutchinson T.A.
        • Thomas D.C.
        • MacGibbon B.
        Predicting survival in adults with end stage renal disease.
        Ann Intern Med. 1982; 96: 417-423
        • Charlson M.E.
        • MacKenzie C.R.
        • Gold J.P.
        • Ales K.L.
        • Topkins M.
        • Fairclough G.F.
        • Shires G.T.
        Pre-operative and intra-operative hemodynamic predictors of postoperative myocardial infarction or ischemia in patients undergoing non-cardiac surgery.
        Ann Surg. 1989; 210: 637-648
        • Rose G.A.
        • Blackburn H.
        Cardiovascular Survey Methods World Health Organization Monograph. 1968; (Belgium): 172-177
        • Goldman L.
        • Caldera D.L.
        • Nussbaum S.R.
        • Southwick F.S.
        • Krogstad D.
        • Murray B.
        • Burke D.S.
        • O'Malley T.A.
        • Goroll A.H.
        • Caplan C.H.
        • Nolan J.
        • Carabello B.
        • Slater E.E.
        Multifactorial index of cardiac risk in noncardiac surgical procedures.
        N Engl J Med. 1977; 297: 845-850
      1. The LIFETEST Procedure. 2nd edn. SAS Technical Report P-179 Additional SAS/STAT Procedures. SAS Institute, Cary NC1988
      2. The PHREG Procedure. 2nd edn. SAS Technical Report P-217 SAS/STAT Software. SAS Institute, Cary NC1991 (Version 6)
        • Kaplan M.H.
        • Feinstein A.R.
        The importance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus.
        J Chron Disease. 1974; 27: 387-404