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Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
GONZALEZ SILVA, Yolanda et al. Utility of the Charlson Comorbidity Index in older people and concordance with other comorbidity indices. Rev Clin Med Fam [online]. 2021, vol.14, n.2, pp.64-70. Epub 26-Jul-2021. ISSN 2386-8201.
Background:
The main aim of our study was to evaluate the current usefulness of the CCI in predicting mortality in older people and the concordance between various comorbidity indices.
Design:
An observational, concurrent cohort study was performed.
Location:
Internal Medicine Service of a tertiary hospital, outpatients in a health centre and residents in four nursing homes.
Participants:
375 individuals ≥65 years and with expected survival ≥6 months, without cognitive impairment.
Main measurements:
Three indices, the CCI, the Geriatric Index of comorbidity (GIC), and the Kaplan-Feinstein index (KFI), were administered in all participants. At 12 months, mortality was evaluated. The data were analyzed using the SPSS 23.0 statistical programme.
Results:
Average age 81.4 years. The CCI revealed low-medium comorbidity in the outpatient group aged 65-75: 43 (75.4%), moderate-high morbidity and more common in hospitalized patients: 19 (61.3%) and nursing homes: 5 (62.5%). At one year follow-up 59 (16.1%) individuals died: CCI: 10 (6.4%) low-medium and 49 (23.3%) moderate-high comorbidity, OR 3.63 (95% CI 1.76-7.51); KF: 27 (13.3%) low-medium and 32 (19.5%) moderate-high comorbidity, OR 1.38 (95% CI 0.78-2.44) and GIC: 45 (14.1%) low-medium and 14 (29.2%) moderate-high comorbidity, OR 2.47 (95% CI 1.21-5.06). The concordance between CCI-KF: 65-75 years K=0.62, 76-85 years: K=0.396 and ≥86 years: K=0.255. Concordance between CCI-GIC was: 65-75 years K=0.202, 76-85 years: K=0.069 and ≥86 years: K=0.118.
Conclusion:
CCI was found to be the best predictor of mortality after one year of follow up. There was considerable concordance between CCI and KF in the 65-75 years and remaining age groups. Correlation with GIC was low.
Palavras-chave : Comorbidity; Frail elderly; Mortality.