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Modified Charlson Comorbidity Index in predicting early mortality after liver transplantation
M Wasilewicz1, J Raszeja-Wyszomirska, E Wunsch
1Department of Hepatology and Liver Transplantation, M. Curie Hospital, 71-455 Szczecin, Poland.
Insights
The Charlson Comorbidity Index for orthotopic liver transplantation (CCI-OLT) does not predict early mortality. This study found no significant difference in comorbidities between liver transplant patients who survived or died within one month.
Area of Science:
- Hepatology
- Transplantation Medicine
- Clinical Outcomes Research
Background:
- The Charlson Comorbidity Index for orthotopic liver transplantation (CCI-OLT) is a clinical score for assessing long-term survival after liver transplantation.
- Its utility in predicting early post-transplant mortality remains uninvestigated.
Purpose of the Study:
- To evaluate the Charlson Comorbidity Index for orthotopic liver transplantation (CCI-OLT) as a predictor of 1-month mortality after orthotopic liver transplantation (OLT).
Main Methods:
- A cohort of 169 patients undergoing OLT between March 2002 and February 2009 was analyzed, excluding those with fulminant hepatic failure or regrafts.
- The CCI-OLT was assessed for all included patients.
- Comorbidity data was compared between survivors and non-survivors within 1 month post-transplantation.
Main Results:
- 146 patients (86%) survived beyond 1 month, while 23 (14%) died.
- No significant difference was observed in the frequency, number, or type of comorbidities included in the CCI-OLT between the survivor and non-survivor groups (30.1% vs 30.4%, P > .99).
- Diabetes mellitus was the most common comorbidity in both groups.
Conclusions:
- The CCI-OLT is not a reliable predictor of early (1-month) mortality following orthotopic liver transplantation.
- The index's predictive value appears limited to long-term survival assessments.
Background:
The Charlson Comorbidity Index for orthotopic liver transplantation (CCI-OLT) is a modified clinical score recently proposed to be useful for the assessment of long-term survival after OLT. It includes 9 associated conditions selected upon a multivariate analysis of a large cohort of transplant recipients. Its role in predicting early mortality after OLT has not yet been investigated. We sought to CCI-OLT as a potential predictor of 1-month mortality after OLT.
Materials/Methods:
One hundred ninety-seven OLT were performed in our center between March 2002 and February 2009. After exclusion of patients who underwent transplantation for fulminant hepatic failure or those who underwent regrafting, we included a group of 169 patients. Viral (39%) and alcohol-induced (23%) cirrhosis were the most common indications for OLT. The CCI-OLT index was assessed in all patients.
Results:
In total, 146 (86%) subjects survived and 23 (14%) died within 1 month after LT. Fifty-one (30%) patients suffered at least 1 comorbidity that was included in the CCI-OLT. Direct comparison between survivor versus nonsurvivor groups showed no significant difference in terms of the total frequency of comorbidities (30.1% vs 30.4%; P > .99) or the number or the type of comorbidity. The most commonly associated condition in both groups was diabetes mellitus.
Conclusion:
Unlike the case of long-term survival, CCI-OLT did not seem to predict early (1-month) mortality after OLT.
