Prognostic Value of the Charlson Comorbidity Index in Pulmonary Embolism

Golpe, Rafael; Pérez-de-Llano, Luis; Castro‐Añón, Olalla

doi:10.1159/000346982

Cited by 10 publications

(3 citation statements)

References 6 publications

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“…Most of these were not eligible because they were clearly not relevant (2711, 5276 and 945, respectively) or because they did not meet selection criteria (328, 459 and 51, respectively). From 176 publications that were retained from these databases (88, 84 and 4, respectively) and from 10 additional publications from other sources, 75 were removed as duplicate records that had been found in more than one database and 40 were excluded for various reasons ( figure 1 ): unmet criteria, 25–48 duplicate, 49–52 selective population, 53–56 journal club, 57–59 comment letter, 60 algorithm, 61 long-term outcome, 62 reliability study 63 and very old variables in the model. 64…”

Section: Resultsmentioning

confidence: 99%

Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis

et al. 2016

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ObjectiveTo review the evidence for existing prognostic models in acute pulmonary embolism (PE) and determine how valid and useful they are for predicting patient outcomes.DesignSystematic review and meta-analysis.Data sourcesOVID MEDLINE and EMBASE, and The Cochrane Library from inception to July 2014, and sources of grey literature.Eligibility criteriaStudies aiming at constructing, validating, updating or studying the impact of prognostic models to predict all-cause death, PE-related death or venous thromboembolic events up to a 3-month follow-up in patients with an acute symptomatic PE.Data extractionStudy characteristics and study quality using prognostic criteria. Studies were selected and data extracted by 2 reviewers.Data analysisSummary estimates (95% CI) for proportion of risk groups and event rates within risk groups, and accuracy.ResultsWe included 71 studies (44 298 patients). Among them, 17 were model construction studies specific to PE prognosis. The most validated models were the PE Severity Index (PESI) and its simplified version (sPESI). The overall 30-day mortality rate was 2.3% (1.7% to 2.9%) in the low-risk group and 11.4% (9.9% to 13.1%) in the high-risk group for PESI (9 studies), and 1.5% (0.9% to 2.5%) in the low-risk group and 10.7% (8.8% to12.9%) in the high-risk group for sPESI (11 studies). PESI has proved clinically useful in an impact study. Shifting the cut-off or using novel and updated models specifically developed for normotensive PE improves the ability for identifying patients at lower risk for early death or adverse outcome (0.5–1%) and those at higher risk (up to 20–29% of event rate).ConclusionsWe provide evidence-based information about the validity and utility of the existing prognostic models in acute PE that may be helpful for identifying patients at low risk. Novel models seem attractive for the high-risk normotensive PE but need to be externally validated then be assessed in impact studies.

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Section: Resultsmentioning

confidence: 99%

Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis

et al. 2016

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“…In addition, patients with a Charlson comorbidity index of 0 appear to have a very favourable outcome, with long-term survival similar to the age-and sex-matched general population. Although the outcome data were obtained from a death registry, the results have been extrapolated successfully to other patient groups [32].…”

Section: Pulmonary Vascular Diseases | J De Miguel-díez Et Almentioning

confidence: 99%

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

et al. 2014

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“… 21 These findings were confirmed by Golpe et al in the same patient cohort. 22 In a similar study examining 176 patients who presented to a Chinese hospital between 2010 and 2012, patients with a CCI ≥1 were more likely to have died 2 years after hospital discharge and each 1-point increase in the CCI score carried a 1.76 increased risk of mortality at this endpoint. 23 A recently published study by Keller et al analyzing a nationwide cohort of German patients also found higher comorbidity burden according to the CCI to be related to the risk of in-hospital mortality.…”

Section: Discussionmentioning

confidence: 97%

Charlson and Elixhauser Comorbidity Indices for Prediction of Mortality and Hospital Readmission in Patients With Acute Pulmonary Embolism

O’Hara,

Pozin,

Abourahma

et al. 2024

Clin Appl Thromb Hemost

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Several risk stratification systems aid clinicians in classifying pulmonary embolism (PE) severity and prognosis. We compared 2 clinical PE scoring systems, the PESI and sPESI scores, with 2 comorbidity indices, the Charlson Comorbidity Index (CCI) and the val Walraven Elixhauser Comorbidity Index (ECI), to determine the utility of each in predicting mortality and hospital readmission. Information was collected from 436 patients presenting with PE via retrospective chart review. The PESI, sPESI, CCI, and ECI scores were calculated for each patient. Multivariate analysis was used to determine each system's ability to predict in-hospital mortality, 90-day mortality, overall mortality, and all-cause hospital readmission. The impact of various demographic and clinical characteristics of each patient on these outcomes was also assessed. The PESI score was found to be an independent predictor of in-hospital mortality and 90-day mortality. The PESI score and the CCI were able to independently predict overall mortality. None of the 4 risk scores independently predicted hospital readmission. Other factors including hypoalbuminemia, serum BNP, coagulopathy, anemia, and diabetes were associated with increased mortality and readmission at various endpoints. The PESI score was the best tool for predicting mortality at any endpoint. The CCI may have utility in predicting long-term outcomes. Further work is needed to better determine the roles of the CCI and ECI in predicting patient outcomes in PE. The potential prognostic implications of low serum albumin and anemia at the time of PE also warrant further investigation.

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Prognostic Value of the Charlson Comorbidity Index in Pulmonary Embolism

Cited by 10 publications

References 6 publications

Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis

Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis

Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011

Charlson and Elixhauser Comorbidity Indices for Prediction of Mortality and Hospital Readmission in Patients With Acute Pulmonary Embolism

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