Age adjusted Charlson comorbidity index (a‐CCI) AS a tool to predict 30‐day post‐operative outcome in general surgery patients

Abstract

Introduction Age adjusted Charlson comorbidity index (a‐CCI) is an established scoring system to predict long‐term mortality. However, its role in predicting 30‐day post‐operative outcome in general surgery patients is not well elucidated. Methods This was a prospective observational study. Consecutive patients operated under general anaesthesia between January 2019 and December 2020 were enrolled. Their a‐CCI was calculated and stratified as Grade 0 comorbidities (a‐CCI score = 0), Grade A comorbidities (a‐CCI score = 1 and 2) and Grade B comorbidities (a‐CCI score ≥ 3). Post‐operative complications were graded according to Clavien Dindo (CD) grading system and classified as minor complications (CD Grades I and II), major complications (CD Grades III–IV) and mortality (CD Grade V). Binary logistic regression and multi‐nominal logistic regression analysis were done and relative risk ratios were calculated. Result A total of 925 patients were enrolled. The mean age was 42.75 (14–85 ± 10) years. 31% of our patients had complications within 30 days of surgery which included mortality in 2.7%. Compared with patients with Grade 0 comorbidities, the odds of getting complications is 1.2 times more in patients with Grade A comorbidities and 1.84 times more in patients with Grade B comorbidities (P = 0.205, 0.001 respectively). In comparison to patients with Grade 0 co‐morbidities, risk of mortality is 3 and 17.86 times more in patients with Grade A and Grade B comorbidities (P = 0.121 and < 0.001 respectively). Conclusion a‐CCI has clinical relevance in general surgical patients and can predict early post‐operative outcome. It should be a part of our armamentarium for pre‐operative assessment of surgical patients.