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Charlson comorbidity index as a predictor of in-hospital death in acute ischemic stroke among very old patients: a single-cohort perspective study.
- Source :
-
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2016 Sep; Vol. 37 (9), pp. 1443-8. Date of Electronic Publication: 2016 May 11. - Publication Year :
- 2016
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Abstract
- Chronic diseases are increasing worldwide. Association of two or more chronic conditions is related with poor health status and reduced life expectancy, particularly among elderly patients. Comorbidities represent a risk factor for adverse events in several critical illnesses. We aimed to evaluate if elderly patients are affected by multiple chronic pathologies, assessed by Charlson comorbidity index (CCI), showed a reduced in-hospital survival after ischemic stroke. In a 3-year period, we evaluated all the subjects admitted to our internal medicine department for ischemic stroke. Age, sex, NIHSS score and all the comorbidities were recorded. Days of hospitalization, hospital-related infections and in-hospital mortality were also assessed. For each patient, we evaluated CCI, obtaining four classes: group 1 (CCI: 2-3), group 2 (CCI: 4-5), group 3 (CCI: 6-7) and group 4 (CCI: ≥8). Survival was evaluated with Kaplan-Meier and Cox regression analyses. The complete model considered in-hospital death as the main outcome, days of hospitalization as the time variable and CCI as the main predictor, adjusting for NIHSS, sex and nosocomial infections. Patients in CCI group 3 and 4 had an increased risk of in-hospital mortality, independently of NIHSS, sex and nosocomial infections. Elderly patients with multiple comorbidities have higher risk of in-hospital death when affected by ischemic stroke.
- Subjects :
- Adult
Age Factors
Aged
Cohort Studies
Comorbidity
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prospective Studies
Regression Analysis
Risk Assessment
Risk Factors
Severity of Illness Index
Sex Factors
Brain Ischemia complications
Geriatric Assessment
Hospital Mortality
Stroke etiology
Stroke mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1590-3478
- Volume :
- 37
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 27166707
- Full Text :
- https://doi.org/10.1007/s10072-016-2602-1