Charlson comorbidity index and 1-year poor outcomes in elderly patients undergoing successful percutaneous coronary
1Bandirma Onyedi Eylül University, Department of Cardiology, Balikesir, Turkey.
Insights
The Charlson Comorbidity Index (CCI) significantly predicts 1-year mortality in elderly patients undergoing percutaneous coronary intervention for acute coronary syndrome (ACS). Higher CCI scores indicate a poorer prognosis and increased risk of adverse outcomes.
Area of Science:
- Cardiology
- Geriatrics
- Health Services Research
Background:
- Elderly patients with acute coronary syndrome (ACS) often have multiple comorbidities, increasing mortality risk.
- The Charlson Comorbidity Index (CCI) is a widely used tool to quantify comorbidity burden.
Purpose of the Study:
- To evaluate the impact of the CCI on 1-year mortality and clinical outcomes in elderly patients (≥75 years) after percutaneous coronary intervention (PCI) for ACS.
Main Methods:
- Retrospective analysis of 704 elderly patients (≥75 years) who underwent successful PCI for ACS.
- Patients were stratified into three groups based on CCI scores: 0, 1, and ≥2.
- Outcomes assessed included 1-year all-cause mortality and stroke development.
Main Results:
- Patients with CCI scores ≥2 exhibited significantly higher rates of stroke compared to other groups (P = .005).
- Mortality rates were substantially higher in the CCI ≥2 group (28.4%) versus CCI 1 (7.5%) and CCI 0 (2.6%) (P < .001).
- Multivariate analysis confirmed CCI as an independent predictor of 1-year all-cause mortality (HR: 1.632, P < .001).
Conclusions:
- The CCI is a valuable tool for identifying elderly ACS patients at high risk of poor prognosis after PCI.
- CCI scores can inform treatment strategies and follow-up management for this vulnerable population.
Abstract:
Elderly patients with acute syndrome are frailer due to the burden of comorbidity. Comorbidities that increase with age result in an increased risk of mortality in patients with acute coronary syndrome (ACS). Many scales have been developed to assess the burden of comorbidity, including the Charlson Comorbidity Index (CCI). The aim of our study is to show the effect of the CCI on 1-year mortality and poor clinical outcomes in elderly patients who underwent percutaneous coronary intervention due to ACS. This single-center retrospective study included 704 patients aged 75 years and older. The study population consisted of patients who were admitted to the hospital with ACS between April 2017 and September 2021 and underwent successful percutaneous intervention. The patients were divided into 3 groups according to their CCI scores as CCI 0 (n:156), 1 (n:266), and ≥2 (n:282). Stroke development was significantly higher in patients with CCI scores ≥ 2 compared to the other 2 groups (P = .005). Mortality rates were found to be 28.4%, 7.5%, and 2.6% in patients with CCI ≥ 2, CCI 1, and CCI 0, respectively. The mortality rate of the CCI ≥ 2 group was significantly higher than those of the other 2 groups (P < .001). The multivariate Cox proportional hazard regression model showed that CCI was an independent predictor for 1-year all-cause mortality (hazard ratio: 1.632; 95% confidence interval: 1.403-1.898; P < .001). CCI may contribute to treatment and follow-up management, as it indicates a poor prognosis in elderly patients who have undergone percutaneous coronary intervention.
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