
Evaluation of co-morbidity indices in patients admitted for Chronic Obstructive Pulmonary Disease
Author(s) -
Richard G. Pinckney,
R.A. O'Brien,
Jay F. Piccirillo,
Benjamin Littenberg
Publication year - 2004
Publication title -
monaldi archives for chest disease. pulmonary series/monaldi archives for chest disease/monaldi archives for chest disease. cardiac series
Language(s) - English
Resource type - Journals
eISSN - 2465-101X
pISSN - 1122-0643
DOI - 10.4081/monaldi.2004.683
Subject(s) - medicine , copd , pulmonary disease , hazard ratio , proportional hazards model , emergency medicine , intensive care medicine , confidence interval
Background. There is limited and conflicting information on the use of co-morbidity instruments to predict mortality in patients with chronic obstructive pulmonary disease (COPD). Methods. We sought to test the validity of the Charlson Index and another co-morbidity instrument, the Adult co-morbidity evaluation 27 (ACE-27), in patients admitted with COPD exacerbations. Co-morbidity scores were obtained by chart review. Information on mortality was retrieved from the Social Security Death Index. We examined the predictive validity of the Charlson and the ACE- 27 using survival analysis. Results. There were 112 patients eligible for the study. The ACE-27 but not the Charlson predicted survival, after adjusting for age, gender, and smoking history in Cox regression, hazard ratio (95% CI) of 1.99 (1.17-3.39). Conclusions. This study confirms earlier findings that the Charlson Index is not a reliable predictor of mortality in patients with COPD. However, the ACE-27 appears to be useful for predicting survival in this study.