Abdulkerim Yıldız, Ali Ramazan Benli, Ali Yiğit

The prognostic role of Charlson comorbidity index for critically ill elderly patients

Objectives: Comorbidities represent a risk factor for adverse events in several critical illnesses. The aim ofthis study was to identify the relationship between the Charlson Comorbidity Index (CCI) with mortality andlength of stay (LOS) in critically ill elderly patients.Methods: A retrospective analysis was made of patients admitted to our tertiary adult intensive care unit (ICU)between January 2015 and January 2016. The impact of comorbidity was evaluated with the CCI. Otherrequired data were retrieved from the patients' follow-up records.Results: The study included a total of 251 patients. The mean age was 78.79 ± 6.70 years. The total mortalityrate was 41.0%. The most common cause for admission was sepsis and acute respiratory failure (18.3% vs18.3%). The median APACHE II score was significantly higher in non-survivors than survivors (31.0 [13.0-47.0] vs 21.0 [9.0-40.0]; p < 0.01). The median CCI was 2.0 (0.0-7.0) for survivors and 3.0 (1.0-10.0) fornon-survivors. The CCI of non-survivors was significantly higher than that of survivors (p = 0.005). Patientswith CCI > 3 had higher mortality than those with CCI ≤ 3 (p < 0.05). The odds ratio of the APACHE II scorefor mortality was 1.214 (95% CI: 1.154-1.276), and for CCI it was 1.320 (95% CI: 1.088-1.602). There was asignificant positive correlation between CCI and LOS (r = 0.147; p = 0.020).Conclusions: CCI is strongly associated with both mortality and LOS. It can be used as a prognostic markerfor elderly patients in critical care.

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