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Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012

Objective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre obse... Full description

Journal Title: Heart (British Cardiac Society) 2014, Vol.100 (4), p.288-294
Main Author: Radovanovic, Dragana
Other Authors: Seifert, Burkhardt , Urban, Philip , Eberli, Franz R , Rickli, Hans , Bertel, Osmund , Puhan, Milo A , Erne, Paul
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: BMJ Publishing Group Ltd
ID: ISSN: 1355-6037
Link: https://www.ncbi.nlm.nih.gov/pubmed/24186563
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title: Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012
format: Article
creator:
  • Radovanovic, Dragana
  • Seifert, Burkhardt
  • Urban, Philip
  • Eberli, Franz R
  • Rickli, Hans
  • Bertel, Osmund
  • Puhan, Milo A
  • Erne, Paul
subjects:
  • 610 Medicine & health
  • Abridged Index Medicus
  • Acute coronary syndrome
  • Acute Coronary Syndrome - epidemiology
  • Acute Coronary Syndrome - therapy
  • Acute coronary syndromes
  • Aged
  • Biostatistics
  • Care and treatment
  • Chronic illnesses
  • Comorbidity
  • Diabetes
  • Diabetes Mellitus - epidemiology
  • Epidemiology
  • Evaluation
  • Family medical history
  • Female
  • Follow-Up Studies
  • Heart attacks
  • Heart failure
  • Heart Failure - epidemiology
  • Hospital Mortality - trends
  • Hospitals
  • Humans
  • Incidence
  • Inpatients
  • Kidney diseases
  • Liver diseases
  • Male
  • Medical prognosis
  • Metastasis
  • Middle Aged
  • Mortality
  • Myocardial Infarction - epidemiology
  • Myocardial Revascularization - methods
  • Outcome and process assessment (Health Care)
  • Prevention Institute (EBPI)
  • Preventive medicine
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk factors
  • ROC Curve
  • Studies
  • Survival Rate - trends
  • Switzerland - epidemiology
  • Tumors
ispartof: Heart (British Cardiac Society), 2014, Vol.100 (4), p.288-294
description: Objective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1±12.6 years) and 73% were male (64.2±12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of −0.4, 95% CI −1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. ClinicalTrials.gov Identifier NCT01305785
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleValidity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012
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creatorRadovanovic, Dragana ; Seifert, Burkhardt ; Urban, Philip ; Eberli, Franz R ; Rickli, Hans ; Bertel, Osmund ; Puhan, Milo A ; Erne, Paul
creatorcontribRadovanovic, Dragana ; Seifert, Burkhardt ; Urban, Philip ; Eberli, Franz R ; Rickli, Hans ; Bertel, Osmund ; Puhan, Milo A ; Erne, Paul ; AMIS Plus Investigators ; on behalf of the AMIS Plus Investigators
descriptionObjective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1±12.6 years) and 73% were male (64.2±12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of −0.4, 95% CI −1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. ClinicalTrials.gov Identifier NCT01305785
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languageeng
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subject610 Medicine & health ; Abridged Index Medicus ; Acute coronary syndrome ; Acute Coronary Syndrome - epidemiology ; Acute Coronary Syndrome - therapy ; Acute coronary syndromes ; Aged ; Biostatistics ; Care and treatment ; Chronic illnesses ; Comorbidity ; Diabetes ; Diabetes Mellitus - epidemiology ; Epidemiology ; Evaluation ; Family medical history ; Female ; Follow-Up Studies ; Heart attacks ; Heart failure ; Heart Failure - epidemiology ; Hospital Mortality - trends ; Hospitals ; Humans ; Incidence ; Inpatients ; Kidney diseases ; Liver diseases ; Male ; Medical prognosis ; Metastasis ; Middle Aged ; Mortality ; Myocardial Infarction - epidemiology ; Myocardial Revascularization - methods ; Outcome and process assessment (Health Care) ; Prevention Institute (EBPI) ; Preventive medicine ; Prognosis ; Prospective Studies ; Registries ; Risk factors ; ROC Curve ; Studies ; Survival Rate - trends ; Switzerland - epidemiology ; Tumors
ispartofHeart (British Cardiac Society), 2014, Vol.100 (4), p.288-294
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3Eberli, Franz R
4Rickli, Hans
5Bertel, Osmund
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descriptionObjective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1±12.6 years) and 73% were male (64.2±12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of −0.4, 95% CI −1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. ClinicalTrials.gov Identifier NCT01305785
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33Myocardial Infarction - epidemiology
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39Prospective Studies
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titleValidity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012
authorRadovanovic, Dragana ; Seifert, Burkhardt ; Urban, Philip ; Eberli, Franz R ; Rickli, Hans ; Bertel, Osmund ; Puhan, Milo A ; Erne, Paul
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1Abridged Index Medicus
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3Acute Coronary Syndrome - epidemiology
4Acute Coronary Syndrome - therapy
5Acute coronary syndromes
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7Biostatistics
8Care and treatment
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11Diabetes
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15Family medical history
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21Hospital Mortality - trends
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abstractObjective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1±12.6 years) and 73% were male (64.2±12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of −0.4, 95% CI −1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. ClinicalTrials.gov Identifier NCT01305785
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