Original Articles
December 30, 2004
Vol. 61 No. 4 (2004): Pulmonary series
https://doi.org/10.4081/monaldi.2004.683

Evaluation of co-morbidity indices in patients admitted for Chronic Obstructive Pulmonary Disease

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Pulmonary disease, chronic obstructive, co-morbidity, risk adjustment, prognosis
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Authors

R.G. Pinckney
richard.pinckney@vtmednet.org
General Internal Medicine, University of Vermont, Washington University, United States.
R. O’Brien
General Internal Medicine, University of Vermont, Washington University, United States.
J.F. Piccirillo
Otolaryngology, Head and Neck Surgery, Washington University, United States.
B. Littenberg
General Internal Medicine, University of Vermont, Washington University, United States.
Background. There is limited and conflicting information on the use of co-morbidity instruments to predict mortality in patients with chronic obstructive pulmonary disease (COPD). Methods. We sought to test the validity of the Charlson Index and another co-morbidity instrument, the Adult co-morbidity evaluation 27 (ACE-27), in patients admitted with COPD exacerbations. Co-morbidity scores were obtained by chart review. Information on mortality was retrieved from the Social Security Death Index. We examined the predictive validity of the Charlson and the ACE- 27 using survival analysis. Results. There were 112 patients eligible for the study. The ACE-27 but not the Charlson predicted survival, after adjusting for age, gender, and smoking history in Cox regression, hazard ratio (95% CI) of 1.99 (1.17-3.39). Conclusions. This study confirms earlier findings that the Charlson Index is not a reliable predictor of mortality in patients with COPD. However, the ACE-27 appears to be useful for predicting survival in this study.

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“Evaluation of Co-Morbidity Indices in Patients Admitted for Chronic Obstructive Pulmonary Disease”. 2004. Monaldi Archives for Chest Disease 61 (4). https://doi.org/10.4081/monaldi.2004.683.