Charlson comorbidity index independently influences short-term outcomes in aged ICH patients

A new study revealed that the Charlson comorbidity index independently influences short-term outcomes in aged ICH patients by assessing their Comorbid medical conditions. The study results were published in the journal BMC Neurology. 

Intracerebral hemorrhages (ICH) are the most devastating cerebrovascular disease subtype with significant rates of disability and mortality and are significantly more common in the elderly population. As comorbidities are common in aged intracerebral hemorrhage patients the prevalence of ICH in increasingly aged patients will increase accordingly. The CCI scores assess the multiple comorbidities by creating a sum score weighted according to the presence of various conditions. Hence researchers conducted a study to assess whether the Charlson Comorbidity Index (CCI) was associated with in-hospital death and short-term functional outcome in elderly patients (age ≥ 70) with intracerebral hemorrhage (ICH). 

A retrospective cohort study was done by including aged ICH patients who were ≥70 years old and admitted within 24 hours of ICH onset. The CCI was derived using hospital discharge ICD-9 CM codes and patient history obtained from standardized case report forms. Multivariable logistic regression was used to determine the independent effect of the CCI score on clinical outcomes. 

Results:

• There were 248 aged ICH patients with comorbid conditions and CCI scores ranging from 2 to 12.
• The CCI score was independently predictive of 1-month functional outcome and in-hospital death as per the Logistic regression.
• Neither ICH volume nor the presence of IVH was an independent predictive factor for the 1-month functional outcome or in-hospital mortality (P < 0.05). 

While the characteristics of the hematoma itself, such as the volume of the ICH and the presence of IVH, appear to have a reduced effect on patient short-term outcomes, the CCI score, which reflects the presence of various comorbidities, may be an independent factor related to the short-term outcomes of elderly patients with ICH in terms of in-hospital mortality and 1-month prognosis. 

Further reading: Zhang, T., Chen, R., Wen, D. et al. The prognostic value of the Charlson comorbidity index in aged patients with intracerebral hemorrhage. BMC Neurol 22, 443 (2022).  https://doi.org/10.1186/s12883-022-02980-z