Comparison of Charlson”s weighted index of comorbidities with the chronic health score for the prediction of mortality in septic patients
Background Comorbidity is one of the most important determinants of short-term and long-term outcomes in septic patients.Charlson”s weighted index of comorbidities (WIC) and the chronic health score (CHS) which is a component of the acute physiology and chronic health evaluation (APACHE) Ⅱ are two frequently-used measures of comorbidity.In this study, we assess the performance of Charlson”s weighted index of comorbidities (WIC) and chronic health score (CHS) in predicting the hospital mortality of intensive care unit (ICU) patients with sepsis.Methods A total of 338 adult patients with sepsis were admitted to a multisystem ICU between October 2010and August 2012.Clinical data were collected including age, gender, underlying diseases, key predisposing causes, severity-of-sepsis, and 28-day mortality.The acute physiology and chronic health evaluation (APACHE) Ⅱ, CHS, acute physiology score (APS), sepsis-related organ failure assessment (SOFA) and WIC scores were assessed within the first 24 hours of admission.Univariate and multiple logistic regression analyses were used to compare the performance of WIC and CHS.The area under the receiver operating characteristic curve (AUC) was used to predict 28-day mortality over classes of risk.Results Of all the enrolled patients, 224 patients survived and 114 patients died.The surviving patients had significantly higher WIC, CHS, APACHE Ⅱ and SOFA scores than the nonsurviving patients(P<0.05).Combining WIC or CHS with other administrative data showed that the 28-day mortality was significantly associated with age, severe sepsis, key predisposing causes such as pneumonia, a history of underlying diseases, such as hypertension and congestive cardiac failure, and WIC, CHS and APS scores (P<0.05).The AUC for the 28-day mortality were 0.564 (95% confidence interval ”CI”0.496-0.631) of CHS, 0.663 (95% CI 0.599-0.727) of WIC, 0.770 (95% CI 0.718-0.822) of APACHEⅡ, 0.856 (95%CI 0.815-0.897) of the CHS combined with other administrative data, and 0.857 (95%CI 0.817-0.897) of the WIC combined with other administrative data.Conclusions The WIC and CHS scores might be independent determinants for in-hospital mortality among ICU patients with sepsis.WIC might be an even better predictor than CHS of the mortality of septic patients with comorbidities.
WIC APACHE Ⅱ SOFA Sepsis Outcome
Yun-Liang CUI Zhao-Tao TIAN Zhao-Fen LIN De-Chang CHE
Center of Emergency and Intensive Care,Jinan Military General Hospital,Shandong,China Department of Emergency Medicine,Changzheng Hospital,Second Military Medical University,Shanghai,Chi
国内会议
山东病理生理学会危重病医学专业委员会第九届学术大会暨山东省医师协会急救医学医师分会第四届学术大会
山东济宁
英文
280-289
2013-10-18（万方平台首次上网日期，不代表论文的发表时间）