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Üçüncü basamak bir hastaneye başvuran çok yaşlı hastalarda Charlson Komorbidite İndeksi ile mortalite tahmini

Yıl 2022, Cilt: 47 Sayı: 1, 199 - 207, 31.03.2022
https://doi.org/10.17826/cumj.1017164

Öz

Amaç: Çoğu ülkede, yaşlı nüfusun acil servislere (AS’ler) giderek artan bir başvuru oranı vardır. Özellikle bu yaşlı hastalar, fonksiyonel ve yaşam kalitesini etkileyen birden fazla komorbiditeye sahip oldukları için genç hastalardan farklıdır. Bu çalışmanın amacı, Charlson komorbidite indeksinin (CCI) çok yaşlı hasta popülasyonunun kısa ve uzun vadeli prognozunu tahmin edip etmediğini belirlemektir.
Gereç ve Yöntem: Çalışma, 2013 ve 2018 yılları arasında Çanakkale Onsekiz Mart Üniversitesi (ÇOMÜ) Hastanesine başvuran 85 yaş ve üstü hastaların acil servis (AS) ziyaretlerinin tanımlayıcı, retrospektif bir analiziydi. Hastaların demografik verileri CCI'ye göre analiz edildi. Değişkenlerin mortaliteyi etkileyip etkilemediğini belirlemek için Cox-regresyon analizleri yapıldı.
Bulgular: Yaş ortalaması 86,96±2,49 olan 85 yaş ve üzeri (507 erkek, 635 kadın) toplam 1142 hasta çalışmaya dahil edildi. Çok değişkenli Cox regresyon analizine göre erkek cinsiyet, CCI ≥6 ve yoğun bakım ünitesine yatış, artan mortalite oranları ile anlamlı şekilde ilişkiliydi.
Sonuç: CCI akut hasta olarak hastaneye yatırılan çok yaşlı hastalarda kısa ve uzun dönem prognozu tahmin eder. CCI, hastaneden taburculukta iyileşmenin bir göstergesi olarak, kabulde, çok yaşlı hastaların seçilmesinde kullanılabilir.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Yok

Kaynakça

  • Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018;13:e0203316.
  • Heeren P, Hendrikx A, Ceyssens J, Devriendt E, Deschodt M, Desruelles D et al. Structure and processes of emergency observation units with a geriatric focus: a scoping review. BMC Geriatr. 2021;21:95.
  • Blomaard LC, Mooijaart SP, Bolt S, Lucke JA, de Gelder J, Booijen AM, Gussekloo J, de Groot B. Feasibility and acceptability of the 'Acutely Presenting Older Patient' screener in routine emergency department care. Age Ageing. 2020;49:1034-41.
  • Berning MJ, Oliveira J E Silva L, Suarez NE, Walker LE, Erwin P, Carpenter CR et al. Interventions to improve older adults' emergency department patient experience: A systematic review. Am J Emerg Med. 2020;38:1257-69.
  • Dresden SM, Lo AX, Lindquist LA, Kocherginsky M, Post LA, French DD et al. The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: Protocol for a randomized controlled trial. Contemp Clin Trials. 2020:106125.
  • Covino M, Petruzziello C, Onder G, Migneco A, Simeoni B, Franceschi F, Ojetti V. A 12-year retrospective analysis of differences between elderly and oldest old patients referred to the emergency department of a large tertiary hospital. Maturitas. 2019;120:7-11.
  • Frenkel WJ, Jongerius EJ, Mandjes-van Uitert MJ, van Munster BC, de Rooij SE. Validation of the Charlson comorbidity index in acutely hospitalized elderly adults: a prospective cohort study. J Am Geriatr Soc. 2014:62:342–6.
  • Le Lagadec MD, Dwyer T. Scoping review: The use of early warning systems for the identification of in-hospital patients at risk of deterioration. Aust Crit Care. 2017;30:211–8.
  • Adams SV, Mader MJ, Bollinger MJ, Wong ES, Hudson TJ, Littman AJ. Utilization of interactive clinical video telemedicine by rural and urban veterans in the veterans health administration health care system. J Rural Health. 2019;35(3):308-18.
  • Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.
  • Yıldız A, Yiğit A, Benli AR. The prognostic role of Charlson comorbidity index for critically ill elderly patients. Eur Res J. 2020;6:67-72.
  • Gunnerson KJ, Bassin BS, Havey RA, Haas NL, Sozener CB, Medlin RP Jr et al. Association of an emergency department-based intensive care unit with survival and inpatient intensive care unit admissions. JAMA Netw Open. 2019;2:e197584.
  • Olofsson, P., Gellerstedt, M., & Carlström, E. D. Manchester triage in Sweden–interrater reliability and accuracy. International emergency nursing. 2009;17:143-48.
  • Lee JH, Choi JK, Jeong SN, Choi SH. Charlson comorbidity index as a predictor of periodontal disease in elderly participants. J Periodontal Implant Sci. 2018;48:92-102.
  • Jepsen P. Comorbidity in cirrhosis. World J Gastroenterol. 2014;20:7223–30.
  • Quach S, Hennessy DA, Faris P, Fong A, Quan H, Doig C. A comparison between the APACHE II and Charlson index score for predicting hospital mortality in critically ill patients. BMC Health Serv Res. 2009;9:129.
  • Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173:676-82.
  • Kabboord AD, van Eijk M, van Dingenen L, Wouters M, Koet M, van Balen R et al. Reliability and usability of a weighted version of the functional comorbidity index. Clin Interv Aging. 2019;14:289-99.
  • Suzuki H, Hanai N, Nishikawa D, Fukuda Y, Koide Y, Kodaira T et al. The Charlson comorbidity index is a prognostic factor in sinonasal tract squamous cell carcinoma. Jpn J Clin Oncol. 2016;46:646-51.
  • Narayan SW, Nishtala PS. Development and validation of a medicines comorbidity index for older people. Eur J Clin Pharmacol. 2017;73:1665–72.
  • Ouchi K, Strout T, Haydar S, Baker O, Wang W, Bernacki R et al. Association of emergency clinicians' assessment of mortality risk with actual 1-month mortality among older adults admitted to the hospital. JAMA Netw Open. 2019;2:e1911139.
  • Zhiting G, Jingfen J, Shuihong C, Minfei Y, Yuwei W, Sa W. Reliability and validity of the four-level Chinese emergency triage scale in mainland China: A multicenter assessment. Int J Nurs Stud. 2020;101:103447.
  • Schmid F, Malinovska A, Weigel K, Bosia T, Nickel CH, Bingisser R. Construct validity of acute morbidity as a novel outcome for emergency patients. PLoS One. 2019;14(1):e0207906.
  • Iversen AKS, Kristensen M, Østervig RM, Køber L, Sölétormos G, Lundager Forberg J et al. A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department. Emerg Med J. 2019;36:66–71.

Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital

Yıl 2022, Cilt: 47 Sayı: 1, 199 - 207, 31.03.2022
https://doi.org/10.17826/cumj.1017164

Öz

Purpose: In most countries, there is an ever-increasing admission rate of the elderly population into emergency departments (EDs). In particular, these elderly patients differ from younger patients because they have multiple comorbidities that affect the functionality and quality of life. The goal of this study is to reveal whether the Charlson comorbidity index (CCI) foresee the short- and long-term prognosis of the super-elderly patient population.
Materials and Methods: The study was a descriptive, retrospective analysis of emergency department (ED) admissions by patients over 85 years of age and admitted to the Canakkale Onsekiz Mart University (COMU) Hospital between 2013 and 2018. The demographic data of the patients were analyzed according to CCI. Cox-regression analyses were conducted to determine whether the variables affected mortality.
Results: A total of 1142 patients aged 85 and older (507 men, 635 women) with a mean age of 86.96±2.49 were included in the study. According to the multivariable Cox regression analysis male gender, CCI ≥6 and ICU admission were significantly associated with increased mortality rates
Conclusion: The CCI predicts short and long-term prognosis in acutely ill, hospitalized super-elderly patients. The CCI could be used to select super-elderly patients at admission as an indicator of improvement at hospital discharge.

Proje Numarası

yok

Kaynakça

  • Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018;13:e0203316.
  • Heeren P, Hendrikx A, Ceyssens J, Devriendt E, Deschodt M, Desruelles D et al. Structure and processes of emergency observation units with a geriatric focus: a scoping review. BMC Geriatr. 2021;21:95.
  • Blomaard LC, Mooijaart SP, Bolt S, Lucke JA, de Gelder J, Booijen AM, Gussekloo J, de Groot B. Feasibility and acceptability of the 'Acutely Presenting Older Patient' screener in routine emergency department care. Age Ageing. 2020;49:1034-41.
  • Berning MJ, Oliveira J E Silva L, Suarez NE, Walker LE, Erwin P, Carpenter CR et al. Interventions to improve older adults' emergency department patient experience: A systematic review. Am J Emerg Med. 2020;38:1257-69.
  • Dresden SM, Lo AX, Lindquist LA, Kocherginsky M, Post LA, French DD et al. The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: Protocol for a randomized controlled trial. Contemp Clin Trials. 2020:106125.
  • Covino M, Petruzziello C, Onder G, Migneco A, Simeoni B, Franceschi F, Ojetti V. A 12-year retrospective analysis of differences between elderly and oldest old patients referred to the emergency department of a large tertiary hospital. Maturitas. 2019;120:7-11.
  • Frenkel WJ, Jongerius EJ, Mandjes-van Uitert MJ, van Munster BC, de Rooij SE. Validation of the Charlson comorbidity index in acutely hospitalized elderly adults: a prospective cohort study. J Am Geriatr Soc. 2014:62:342–6.
  • Le Lagadec MD, Dwyer T. Scoping review: The use of early warning systems for the identification of in-hospital patients at risk of deterioration. Aust Crit Care. 2017;30:211–8.
  • Adams SV, Mader MJ, Bollinger MJ, Wong ES, Hudson TJ, Littman AJ. Utilization of interactive clinical video telemedicine by rural and urban veterans in the veterans health administration health care system. J Rural Health. 2019;35(3):308-18.
  • Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.
  • Yıldız A, Yiğit A, Benli AR. The prognostic role of Charlson comorbidity index for critically ill elderly patients. Eur Res J. 2020;6:67-72.
  • Gunnerson KJ, Bassin BS, Havey RA, Haas NL, Sozener CB, Medlin RP Jr et al. Association of an emergency department-based intensive care unit with survival and inpatient intensive care unit admissions. JAMA Netw Open. 2019;2:e197584.
  • Olofsson, P., Gellerstedt, M., & Carlström, E. D. Manchester triage in Sweden–interrater reliability and accuracy. International emergency nursing. 2009;17:143-48.
  • Lee JH, Choi JK, Jeong SN, Choi SH. Charlson comorbidity index as a predictor of periodontal disease in elderly participants. J Periodontal Implant Sci. 2018;48:92-102.
  • Jepsen P. Comorbidity in cirrhosis. World J Gastroenterol. 2014;20:7223–30.
  • Quach S, Hennessy DA, Faris P, Fong A, Quan H, Doig C. A comparison between the APACHE II and Charlson index score for predicting hospital mortality in critically ill patients. BMC Health Serv Res. 2009;9:129.
  • Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173:676-82.
  • Kabboord AD, van Eijk M, van Dingenen L, Wouters M, Koet M, van Balen R et al. Reliability and usability of a weighted version of the functional comorbidity index. Clin Interv Aging. 2019;14:289-99.
  • Suzuki H, Hanai N, Nishikawa D, Fukuda Y, Koide Y, Kodaira T et al. The Charlson comorbidity index is a prognostic factor in sinonasal tract squamous cell carcinoma. Jpn J Clin Oncol. 2016;46:646-51.
  • Narayan SW, Nishtala PS. Development and validation of a medicines comorbidity index for older people. Eur J Clin Pharmacol. 2017;73:1665–72.
  • Ouchi K, Strout T, Haydar S, Baker O, Wang W, Bernacki R et al. Association of emergency clinicians' assessment of mortality risk with actual 1-month mortality among older adults admitted to the hospital. JAMA Netw Open. 2019;2:e1911139.
  • Zhiting G, Jingfen J, Shuihong C, Minfei Y, Yuwei W, Sa W. Reliability and validity of the four-level Chinese emergency triage scale in mainland China: A multicenter assessment. Int J Nurs Stud. 2020;101:103447.
  • Schmid F, Malinovska A, Weigel K, Bosia T, Nickel CH, Bingisser R. Construct validity of acute morbidity as a novel outcome for emergency patients. PLoS One. 2019;14(1):e0207906.
  • Iversen AKS, Kristensen M, Østervig RM, Køber L, Sölétormos G, Lundager Forberg J et al. A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department. Emerg Med J. 2019;36:66–71.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma
Yazarlar

Murat Daş 0000-0003-0893-6084

Okan Bardakcı 0000-0001-6829-7435

Gökhan Akdur 0000-0001-8034-0301

İmran Kankaya 0000-0002-8682-091X

Coşkun Bakar 0000-0002-5497-2759

Okhan Akdur 0000-0003-3099-6876

Yavuz Beyazıt 0000-0001-6247-2714

Proje Numarası yok
Yayımlanma Tarihi 31 Mart 2022
Kabul Tarihi 24 Ocak 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 47 Sayı: 1

Kaynak Göster

MLA Daş, Murat vd. “Prediction of Mortality With Charlson Comorbidity Index in Super-Elderly Patients Admitted to a Tertiary Referral Hospital”. Cukurova Medical Journal, c. 47, sy. 1, 2022, ss. 199-07, doi:10.17826/cumj.1017164.