Validation of the Charlson Comorbidity Index in Acutely Hospitalized Elderly Adults: A Prospective Cohort Study

ObjectivesTo determine whether the Charlson Comorbidity Index (CCI) predicts short- and long-term mortality. DesignProspective cohort study. SettingThe medical department of two university hospitals and one community-based hospital. ParticipantsAcutely hospitalized individuals aged 65 and older with a mean age of 77.87.9, 45.8% male (n=1,313). MeasurementsIn eligible persons, information on demographic characteristics, activities of daily living (modified Katz ADL Index score), and disease-related measures was collected within 48hours after admission. Follow-up using self-reporting questionnaires was performed at 3months and 1year. Functional decline was defined as a decline of at least 1 point on the modified Katz ADL Index score at 12months from baseline. Mortality data at 3months and 1 and 5years were collected from the municipal database. ResultsLogistic regression analysis, adjusted for age and sex, showed that participants with a CCI of 5 or more had higher 3-month (odds ratio (OR)=3.6, 95% confidence interval (CI)=2.1-6.4), 1-year (OR=7.1, 95% CI=4.2-11.9), and 5-year (OR=52.4, 95% CI=13.3-206.4) mortality than those with a CCI of 0. Participants with CCI scores between 1 and 4 also had greater mortality risk at 3months and 1 and 5years. ConclusionThe CCI independently predicts short- and long-term mortality in acutely ill hospitalized elderly adults.