Charlson's weighted index of comorbidities is useful in assessing the risk of death in septic patients

被引:47
作者
Oltean, Simona [1 ,2 ]
Tatulescu, Doina [1 ,2 ]
Bondor, Cosmina [3 ]
Slavcovici, Adriana [1 ,2 ]
Cismaru, Cristina [1 ,2 ]
Lupse, Mihaela [1 ,2 ]
Muntean, Monica [1 ,2 ]
Jianu, Cristian [2 ]
Marcu, Cristian [1 ,2 ]
Oltean, Mihai [4 ,5 ]
机构
[1] Iuliu Hatieganu Univ Med & Pharm, Dept Infect Dis, Cluj Napoca 400348, Romania
[2] Clin Infect Dis, Cluj Napoca 400348, Romania
[3] Iuliu Hatieganu Univ Med & Pharm, Dept Med Informat & Biostat, Cluj Napoca 400349, Romania
[4] Sahlgrens Univ Hosp, Sahlgrenska Transplant Inst, S-41345 Gothenburg, Sweden
[5] Univ Gothenburg, Dept Surg, Sahlgrenska Acad, S-41345 Gothenburg, Sweden
关键词
Sepsis; Comorbidities; Charlson's WIC; Prognostic; ORGAN FAILURE ASSESSMENT; SYSTEMIC INFLAMMATORY RESPONSE; SEVERE SEPSIS; ASSESSMENT SCORE; APACHE-II; MORTALITY; BACTEREMIA; ADJUSTMENT; ADULTS; DEFINITIONS;
D O I
10.1016/j.jcrc.2011.08.021
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose: We investigated the efficiency of the Charlson's weighted index of comorbidities (WIC) in predicting the risk of death in septic patients. Materials and Methods: A single-center, 3-year analysis of all septic patients was conducted; WIC and organ failure assessed using the Sepsis-related Organ Failure Assessment (SOFA) score were calculated retrospectively. Results: Of 250 septic patients, 60 patients (34%) had WIC above 2. Fifty-five patients (22%) died during the hospitalization. Increasing WIC was associated with increased mortality. Mean WIC differed significantly between survivors and nonsurvivors (P < .0001), and the univariate logistic regression revealed that risk of death depends significantly of WIC with odds ratio of 1.59 (95% confidence interval, 1.31-1.93; P < .001). The accuracy of prediction for the risk of death was 79.2%. Receiver operating characteristics curve indicated a WIC of 2 as a cutoff value, the association between WIC greater than 2, and the risk of death being described by an odds ratio of 1.87 (95% confidence interval, 1.017-3.457; P = .042); the area under the receiver operating characteristics curve in predicting mortality was 0.81 for the SOFA score and 0.68 for WIC; WIC correlated positively with SOFA (r = 0.27; P < .0001). Conclusion: In septic patients, WIC is predictive for hospital mortality, and the risk of death significantly depends on WIC. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:370 / 375
页数:6
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