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Is the Charlson comorbidity index a good predictor of mortality and adverse effects in proximal humerus fractures?

Ana Belén Fernández-Cortiñas1, Jesús Vidal Campos2, Xavier Paredes-Carnero3

  • 1Department of Orthopaedic Surgery, Complutense University of Madrid, Madrid, Spain; Cosaga Hospital and Complexo Hospitalario Universitario de Ourense, Ourense, Spain.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|February 16, 2019
PubMed

Insights

The Charlson Comorbidity Index (CCI) effectively predicts mortality risk in patients with proximal humerus fractures (PHF). Higher CCI scores correlate with increased mortality and adverse events in PHF patients.

Area of Science:

  • Orthopedics
  • Geriatric Medicine
  • Epidemiology

Background:

  • Proximal humerus fractures (PHF) are common in the elderly, increasing morbidity and mortality.
  • The Charlson Comorbidity Index (CCI) assesses comorbidity and predicts mortality risk.

Purpose of the Study:

  • To evaluate the Charlson Comorbidity Index (CCI) as a predictor of mortality in patients with proximal humerus fractures (PHF).
  • To determine the relationship between CCI and the incidence of adverse events in PHF patients.

Main Methods:

  • Retrospective study with prospective data collection of 354 PHF patients (2013-2015).
  • Minimum follow-up of 24 months (mean 51.1 months).
  • Collected data on adverse events, mortality, and calculated CCI for all patients.

Main Results:

  • Patients with CCI > 5 had a 4.6 times higher mortality risk (95% CI [2.4-9.0]) compared to those with CCI < 5.
  • 40 (11%) patients died during follow-up (mean 4.3 years).
  • Higher average CCI was associated with systemic complications (p=0.001) and increased mortality risk (HR=6.6; 95% CI [3.5-12.4]).

Conclusions:

  • The CCI is a reliable predictor of mortality in patients with proximal humerus fractures.
  • A correlation exists between CCI and the development of adverse effects in PHF patients.
  • CCI should be considered in therapeutic decision-making for PHF patients.
Abstract

Keywords:
Adverse effectsCharlson comorbidity indexComorbidityMortalityProximal humerus fractures

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