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The Association Between Charlson Comorbidity Index in Different Comorbidities and ICU Admission in Patients with

Wei Shen1, Chun-Fa Cheng1

  • 1Vascular Hernia Surgery, The First People's Hospital of Linping District, Hangzhou, China.

Journal of Intensive Care Medicine
|December 9, 2025
PubMed

Insights

The Charlson Comorbidity Index (CCI) is linked to Intensive Care Unit (ICU) admission in aortic aneurysm (AA) patients. Combining CCI with other factors improves prediction, especially for patients with hypertension.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Medical Informatics

Background:

  • Aortic aneurysm (AA) patients often have multiple comorbidities.
  • Predicting Intensive Care Unit (ICU) admission in AA patients is crucial for resource allocation and patient management.
  • The Charlson Comorbidity Index (CCI) is a widely used measure of comorbidity burden.

Purpose of the Study:

  • To investigate the association between the Charlson Comorbidity Index (CCI) and ICU admission in aortic aneurysm (AA) patients.
  • To evaluate the predictive performance of CCI alone and in combination with other factors for ICU admission in AA patients.
  • To identify specific comorbidities that influence the relationship between CCI and ICU admission.

Main Methods:

  • Retrospective analysis of 996 patient records from the MIMIC-IV database.
  • Logistic regression analysis to assess the relationship between CCI and ICU admission.
  • Receiver Operating Characteristic (ROC) curve and Decision Curve Analysis (DCA) to evaluate prediction efficacy and clinical benefits.
  • Development of CCI-based models to assess predictive improvements.

Main Results:

  • CCI was independently associated with ICU admission in AA patients, particularly those with hypertension, coronary heart disease, hyperlipidemia, and congestive heart failure.
  • Single CCI showed limited prediction performance (AUC < 0.7) and clinical net benefit across comorbidities.
  • CCI-based models combining with other independent factors significantly improved prediction performance and clinical net benefit.
  • The best predictive performance was observed in patients with hypertension (AUC = 0.752).

Conclusions:

  • The Charlson Comorbidity Index (CCI) is an independent predictor of ICU admission in aortic aneurysm (AA) patients.
  • Integrating CCI with other clinical factors enhances predictive value for ICU admission in AA patients.
  • The predictive utility of CCI-based models is particularly pronounced in AA patients with hypertension.

Keywords:
Charlson comorbidity indexICU admissionMIMICaortic aneurysmcomorbidity

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