The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD
Background Since comorbid conditions are frequently present in chronic obstructive pulmonary disease (COPD) and affect outcome, a composite scoring system to quantify comorbidity might be helpful in assessing mortality risk. Methods We tested the hypothesis that the Charlson Comorbidity Index (CCI)...
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SAGE Publishing
2025-01-01
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| Series: | Journal of Multimorbidity and Comorbidity |
| Online Access: | https://doi.org/10.1177/26335565251315876 |
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| author | Kevin Ly Dorothy Wakefield Richard ZuWallack |
| author_facet | Kevin Ly Dorothy Wakefield Richard ZuWallack |
| author_sort | Kevin Ly |
| collection | DOAJ |
| description | Background Since comorbid conditions are frequently present in chronic obstructive pulmonary disease (COPD) and affect outcome, a composite scoring system to quantify comorbidity might be helpful in assessing mortality risk. Methods We tested the hypothesis that the Charlson Comorbidity Index (CCI) score at the time of an outpatient medical clinic encounter for COPD predicts all-cause mortality. Cox Proportional Hazards analyses were used in 200 randomly selected patients to relate CCI scores to all-cause mortality out to 5 years. Results Mean age was 62 ± 10 years, 56% were female, FEV1 was 62%, CCI was 3.08 ± 2.30, and 30% had a CCI ≥ 4, indicating 3 or more comorbid conditions. All-cause mortality was 8.5% and 20% at 3 and 5 years, respectively. In univariate testing, the CCI score and hospitalizations predicted mortality, but FEV1 did not. In multivariable testing, which included covariates of age, sex, socioeconomic status, race, FEV1 percent-predicted, and all-cause hospitalizations in the preceding year, CCI expressed as a continuous variable strongly predicted mortality: hazard ratio (HR) 1.38 for each unit increase in the score (p < 0.0001). While 1 or 2 comorbid conditions were not significantly related to mortality, 3 or more comorbid conditions (compared to none) strongly predicted mortality: HR 9.80, 95% CI 3.80 to 25.00. Conclusion Comorbidity, assessed with the CCI, is strongly predictive of mortality in outpatients with a clinical diagnosis of COPD, and this relationship appears to be non-linear. This instrument may be useful in determining prognosis in this population. |
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| institution | Kabale University |
| issn | 2633-5565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
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| series | Journal of Multimorbidity and Comorbidity |
| spelling | doaj-art-85cef1efb1f54179b4a7a95acb60490a2025-01-27T16:03:31ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652025-01-011510.1177/26335565251315876The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPDKevin LyDorothy WakefieldRichard ZuWallackBackground Since comorbid conditions are frequently present in chronic obstructive pulmonary disease (COPD) and affect outcome, a composite scoring system to quantify comorbidity might be helpful in assessing mortality risk. Methods We tested the hypothesis that the Charlson Comorbidity Index (CCI) score at the time of an outpatient medical clinic encounter for COPD predicts all-cause mortality. Cox Proportional Hazards analyses were used in 200 randomly selected patients to relate CCI scores to all-cause mortality out to 5 years. Results Mean age was 62 ± 10 years, 56% were female, FEV1 was 62%, CCI was 3.08 ± 2.30, and 30% had a CCI ≥ 4, indicating 3 or more comorbid conditions. All-cause mortality was 8.5% and 20% at 3 and 5 years, respectively. In univariate testing, the CCI score and hospitalizations predicted mortality, but FEV1 did not. In multivariable testing, which included covariates of age, sex, socioeconomic status, race, FEV1 percent-predicted, and all-cause hospitalizations in the preceding year, CCI expressed as a continuous variable strongly predicted mortality: hazard ratio (HR) 1.38 for each unit increase in the score (p < 0.0001). While 1 or 2 comorbid conditions were not significantly related to mortality, 3 or more comorbid conditions (compared to none) strongly predicted mortality: HR 9.80, 95% CI 3.80 to 25.00. Conclusion Comorbidity, assessed with the CCI, is strongly predictive of mortality in outpatients with a clinical diagnosis of COPD, and this relationship appears to be non-linear. This instrument may be useful in determining prognosis in this population.https://doi.org/10.1177/26335565251315876 |
| spellingShingle | Kevin Ly Dorothy Wakefield Richard ZuWallack The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD Journal of Multimorbidity and Comorbidity |
| title | The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD |
| title_full | The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD |
| title_fullStr | The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD |
| title_full_unstemmed | The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD |
| title_short | The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD |
| title_sort | usefulness of charlson comorbidity index cci scoring in predicting all cause mortality in outpatients with clinical diagnoses of copd |
| url | https://doi.org/10.1177/26335565251315876 |
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