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Published on: June 10, 2020

Charlson comorbidity index adjustment in intracerebral hemorrhage

Barak Bar1, J Claude Hemphill

  • 1Department of Neurology, Brain and Spinal Injury Center, University of California, San Francisco, and Room 4M62, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.

Stroke
|July 30, 2011
PubMed

Insights

Comorbid conditions, measured by the Charlson Comorbidity Index (CCI), significantly impact outcomes in patients with intracerebral hemorrhage (ICH). Higher CCI scores predict poorer functional outcomes and increased mortality after ICH.

Area of Science:

  • Neurology
  • Clinical Epidemiology
  • Medical Informatics

Background:

  • Intracerebral hemorrhage (ICH) outcome prediction models often lack systematic adjustment for comorbid conditions.
  • Understanding the impact of comorbidities is crucial for accurate prognosis in ICH patients.

Purpose of the Study:

  • To evaluate the association between the Charlson Comorbidity Index (CCI) and early mortality and long-term functional outcomes in intracerebral hemorrhage (ICH) patients.
  • To determine if CCI is an independent predictor of ICH patient outcomes.

Main Methods:

  • Retrospective analysis of a prospective observational cohort of 243 ICH patients admitted to UCSF hospitals (2001-2004).
  • Utilized International Classification of Diseases, revision 9 codes and case report forms to derive CCI scores.
  • Assessed 12-month functional outcome using the modified Rankin Scale (mRS).

Main Results:

  • Comorbid conditions were prevalent in the ICH cohort, with CCI scores ranging from 0 to 12.
  • Patients with high CCI scores (≥3) had significantly lower rates of favorable functional outcome (mRS 0-2) at 12 months compared to those with CCI 0 (29% vs. 48%, P=0.02).
  • CCI was an independent predictor of 12-month functional outcome, with higher scores indicating worse prognosis (CCI=2: OR 2.3, P=0.06; CCI≥3: OR 3.5, P=0.001).

Conclusions:

  • Comorbid medical conditions, quantified by the CCI, independently influence patient outcomes after intracerebral hemorrhage.
  • Future research and clinical models predicting ICH outcomes should incorporate the impact of comorbidities for improved accuracy.
Abstract

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