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Evaluation of co-morbidity indices in patients admitted for chronic obstructive pulmonary disease
R G Pinckney1, R O'Brien, J F Piccirillo
1General Internal Medicine, University of Vermont, Burlington 05401, USA. richard.pinckney@vtmednet.org
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.
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