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Age-adjusted Charlson comorbidity index predicts postoperative mortality in elderly patients with hip fracture: A

Dan-Long Zhang1, Yu-Xuan Cong1, Yan Zhuang1

  • 1Department of Trauma and Orthopedic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Frontiers in Medicine
|March 24, 2023
PubMed

Insights

The age-adjusted Charlson comorbidity index (aCCI) significantly predicts mortality in elderly hip fracture patients. Higher aCCI scores correlate with increased postoperative mortality risk, highlighting its predictive value.

Area of Science:

  • Geriatric Medicine
  • Surgical Outcomes
  • Epidemiology

Background:

  • Elderly patients undergoing hip fracture surgery face significant postoperative mortality risks.
  • The age-adjusted Charlson comorbidity index (aCCI) is a potential tool for assessing patient risk.
  • Understanding the association between aCCI and mortality is crucial for clinical decision-making.

Purpose of the Study:

  • To investigate the clinical association between the age-adjusted Charlson comorbidity index (aCCI) and postoperative mortality in elderly patients with hip fractures.
  • To determine if aCCI is a reliable predictor of mortality in this vulnerable population.

Main Methods:

  • A retrospective study included 2,657 elderly patients with hip fractures (January 2015 - September 2019).
  • Demographic and clinical data were collected, and multivariate Cox regression models were employed.
  • The association between aCCI and all-cause mortality was analyzed using EmpowerStats and R software.

Main Results:

  • The mean follow-up was 38.97 months, with an overall mortality rate of 34.14%.
  • A higher aCCI score was significantly associated with increased mortality (HR = 1.31, P < 0.0001).
  • Mortality risk increased progressively with higher aCCI quartiles, demonstrating a linear trend (P < 0.0001).

Conclusions:

  • The age-adjusted Charlson comorbidity index (aCCI) is a strong predictor of three-year mortality following hip fracture in elderly patients.
  • Each one-unit increase in aCCI was associated with a 31% increase in mortality risk.
  • aCCI can aid in risk stratification and management planning for elderly hip fracture patients.
Abstract

Keywords:
Cox regressionage-adjusted Charlson comorbidity indexelderlyhip fracturemortality

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