Assessment of the charlson comorbidity index score, CHADS2 and CHA2DS2-VASc scores in predicting death in patients with thoracic empyema

Wu, Jeng-Yuan; Liu, Chienming; Lee, Shang‐Sen; Kuo, Yu‐Hung; Hsieh, Tsung-Cheng

doi:10.1016/j.hrtlng.2017.12.003

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…Other researchers also reported C-statistics of 0.7 -0.8 for predicting in-hospital mortality using these methods, with differences of < 0.1 between the Charlson/Deyo and Elixhauser methods (Southern et al, 2004;Stukenborg et al, 2001). More recently, researchers in Taiwan reported C-statistics of 0.76 in predicting post-illness mortality in patients with thoracic empyema using Charlson Method (Wu, Liu, Lee, Kuo, & Hsieh, 2018). In addition, in alignment with the Charlson/Deyo agecomorbidity score, we created the new V W Elixhauser age-comorbidity score by adding age points to the Elixhauser composite score; the new score had similar accuracy to the V W Elixhauser comorbidity score in predicting in-hospital mortality and LOS.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Measures to Predict Mortality and Length of Stay in Hospitalized Patients

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Comparison of Measures to Predict Mortality and Length of Stay in Hospitalized Patients

et al. 2019

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“…However, owing to the retrospective nature of the study and the lack of data on some confounding factors, these results need to be prospectively validated in other cohorts. 111 To date, the only outcome-prediction score that has been prospectively studied and externally validated is the RAPID score (Table 2). 9,10 This was created using the two largest multicenter pleural infection studies to date (MIST-1 and MIST-2) 71,79 to create predictors that are clinically accessible at baseline: urea (renal), age, nature of pleural fluid (purulence), infection source (I), and serum albumin (dietary).…”

Section: Risk Stratificationmentioning

confidence: 99%

“…However, owing to the retrospective nature of the study and the lack of data on some confounding factors, these results need to be prospectively validated in other cohorts. 111 …”

Section: Risk Stratificationmentioning

confidence: 99%

Recent Insights into the Management of Pleural Infection

Hassan

Patel

Sadaka

et al. 2021

IJGM

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Pleural infection in adults has considerable morbidity and continues to be a lifethreatening condition. The term "pleural infection" encompasses complicated parapneumonic effusions and primary pleural infections, and includes but is not limited to empyema, which refers to collection of pus in the pleural cavity. The incidence of pleural infection in adults has been continuously increasing over the past two decades, particularly in older adults, and most of such patients have comorbidities. Management of pleural infection requires prolonged duration of hospitalization (average 14 days). There are recognized differences in microbial etiology of pleural infection depending on whether the infection was acquired in the community or in a health-care setting. Anaerobic bacteria are acknowledged as a major cause of pleural infection, and thus anaerobic coverage in antibiotic regimens for pleural infection is mandatory. The key components of managing pleural infection are appropriate antimicrobial therapy and chest-tube drainage. In patients who fail medical therapy by manifesting persistent sepsis despite standard measures, surgical intervention to clear the infected space or intrapleural fibrinolytic therapy (in poor surgical candidates) are recommended. Recent studies have explored the role of early intrapleural fibrinolytics or first-line surgery, but due to considerable costs of such interventions and the lack of convincing evidence of improved outcomes with early use, early intervention cannot be recommended, and further evidence is awaited from ongoing studies. Other areas of research include the role of routine molecular testing of infected pleural fluid in improving the rate of identification of causative organisms. Other research topics include the benefit of such interventions as medical thoracoscopy, high-volume pleural irrigation with saline/antiseptic solution, and repeated thoracentesis (as opposed to chest-tube drainage) in reducing morbidity and improving outcomes of pleural infection. This review summarizes current knowledge and practice in managing pleural infection and future research directions.

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“…The CCI has been shown to be an independent predictor of mortality in various medical patient populations, nonorthopaedic surgical patients, and various orthopaedic surgical patients. [9][10][11][12][13][14][15][16][17][18][19] In the setting of high mortality within spinal trauma, consideration of palliation should be given in certain patient groups based on age, comorbidities, concomitant injuries, and the degree of spinal injury. Our study sought to assess the association of CCI with mortality rates of patients undergoing surgical intervention for spinal trauma at a large academic Level I trauma tertiary center.…”

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confidence: 99%

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confidence: 99%

Association of Mortality and Charlson Comorbidity Index in Surgical Spinal Trauma Patients at a Level I Academic Center

McGee

Levitt

Prather

et al. 2022

J Am Acad Orthop Surg

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Objectives:The Charlson Comorbidity Index score (CCI) records the presence of comorbidities with various weights for a total score to estimate mortality within 1 year of hospital admission. Our study sought to assess the association of CCI with mortality rates of patients undergoing surgical intervention. Study Design: Retrospective study. Methods: Retrospective study of patients with surgical spinal trauma at a large academic level I trauma tertiary center from 2015 to 2018. Information collected included age, sex, American Society of Anesthesiologists physical status, body mass index, Charlson comorbidities, injury severity score, the presence of spinal cord injury, and mortality. Mortality was measured at 30 days, 90 days, and 1 year. Descriptive and bivariate analyses were completed. The results were significant at P , 0.05. Results: The highest proportion of 1-year mortality was in the patients with cervical (11.3%) and thoracolumbar injuries (7.4%) (P = 0.002). Patients with low CCI had low 1-year mortality (1.7%). Patients with high CCI had high 1-year mortality (13.8%) (P , 0.001). A significant association existed between CCI and mortality at 30 days, 90 days, and 1 year (P , 0.001). Mortality was higher in patients with spinal cord injury (14/108; 13%) than in those without (11/232; 5%) (P = 0.021). No association existed between ISS and mortality (P = 0.26). Discussion: The CCI was associated with a higher proportion of deaths at 30 days, 90 days, and 1 year. This association may help predict this unfortunate complication and guide the surgical team in formulating treatment plans and counseling patients and families regarding mortality associated with these injuries and the risks of surgical intervention.A traumatic spinal injury is a broad term that encompasses a range of injuries such as vertebral body fractures, fracture dislocations, ligamentous disruptions, facet joint injuries, spinal cord injuries, and other

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Assessment of the charlson comorbidity index score, CHADS2 and CHA2DS2-VASc scores in predicting death in patients with thoracic empyema

Cited by 7 publications

References 27 publications

Comparison of Measures to Predict Mortality and Length of Stay in Hospitalized Patients

Comparison of Measures to Predict Mortality and Length of Stay in Hospitalized Patients

Recent Insights into the Management of Pleural Infection

Association of Mortality and Charlson Comorbidity Index in Surgical Spinal Trauma Patients at a Level I Academic Center

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