The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices

Yang, Ching‐Chieh; Fong, Y.; Lin, Li‐Ching; Que, Jenny; Ting, Wei; Chang, Chia‐Li; Wu, Hsin-Min; Ho, Chung‐Han; Wang, Jhi‐Joung; Huang, Chung‐I

doi:10.1093/ejcts/ezx215

Cited by 94 publications

(78 citation statements)

References 29 publications

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“…The mean age was 81.9 years (standard deviation (SD) 2.2) in the primary group and 82.3 years (SD 2.2) in the revision group (p = 0.310). The American Society of Anesthesiologists (ASA) score was not different (2.3 (SD 0.4) vs. 2.4 (SD 0.5), p = 0.144), but the age-adjusted Charlson comorbidity index (ACCI) was significantly higher preoperatively in the revision group (4.4 (SD 0.6) vs. 4.8 (SD 0.8), p = 0.003) [11,12]. There were no differences in demographics with regard to sex, operation side, or body mass index, or in the mean follow-up period to the final OPD visit ( Table 2).…”

Section: Demographicsmentioning

confidence: 99%

Mid-term lifetime survivals of octogenarians following primary and revision total knee arthroplasties were satisfactory: a retrospective single center study in contemporary period

Song

Kim

Bae³

et al. 2020

Knee Surg & Relat Res

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Background As life expectancy increases, the number of octogenarians requiring primary and revision total knee arthroplasty (TKA) is increasing. Recently, primary TKA has become a common treatment option in octogenarians. However, surgeons may still be hesitant about performing revision TKA on octogenarians because of concern about risk and cost benefit. The purpose of this study was to investigate clinical outcomes, postoperative complications, and mid-term lifetime survival in octogenarians after primary and revision TKA. Materials and methods We retrospectively reviewed 231 primary TKAs and 41 revision TKAs performed on octogenarians between 2000 and 2016. The mean age of patients undergoing primary TKA was 81.9 years and that of patients undergoing revision TKA was 82.3 years (p = 0.310). The age-adjusted Charlson comorbidity index was higher in revision TKA (4.4 vs. 4.8, p = 0.003). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM) were evaluated. The incidence of postoperative complications (TKA-related, specific or systemic) and lifetime survival rate (endpoint death determined by telephone or mail communication with patient or family) were investigated. Results The WOMAC and ROM improved significantly after primary and revision TKA, although postoperative results were worse in the revision group (33.1 vs. 47.2; 128.9° vs. 113.6°; p < 0.001, respectively). There were no cases of aseptic or septic component failure in either group. One case of periprosthetic fracture was observed in the revision group (0% vs. 2.4%, p = 0.151), and three cases of deep vein thrombosis (DVT)/pulmonary thromboembolism (PTE) (one case of DVT and two cases of PTE) were observed in the primary group (1.3% vs. 0%, p = 1.000). The most common systemic complication in both groups was delirium (7.4% vs. 14.6%, p = 0.131). There were no differences between the two groups in the other systemic complication rates. The 5-year and 10-year lifetime survival rates were 87.2% and 62.9%, respectively, in primary TKA and 82.1% and 42.2%, respectively, in revision TKA (p = 0.017). Conclusions Both primary and revision TKA are viable options for octogenarians, based on the satisfactory clinical outcomes, TKA-related complication rates, and mid-term lifetime survival. Delirium needs to be managed appropriately as the most common systemic complication in both primary and revision TKA in octogenarians. Level of evidence IV

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Section: Demographicsmentioning

confidence: 99%

Mid-term lifetime survivals of octogenarians following primary and revision total knee arthroplasties were satisfactory: a retrospective single center study in contemporary period

Song

Kim

Bae³

et al. 2020

Knee Surg & Relat Res

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“…exclusions, which should be based on other factors such as physiological status. Additionally, patients with increasing comorbidity burden have increased risk of postoperative complications after lung cancer surgery [30]. In one study conducted during the era of the present analysis, up to 50% of patients undergoing lung cancer resection had at least three comorbidities [31].…”

Section: Plos Onementioning

confidence: 73%

Increased reporting but decreased mortality associated with adverse events in patients undergoing lung cancer surgery: Competing forces in an era of heightened focus on care quality?

et al. 2020

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Introduction Advances in surgical techniques have improved clinical outcomes and decreased complications. At the same time, heightened attention to care quality has resulted in increased identification of hospital-acquired adverse events. We evaluated these divergent effects on the reported safety of lung cancer resection. Methods and materials We analyzed hospital-acquired adverse events in patients undergoing lung cancer resection using the National Hospital Discharge Survey (NHDS) database from 2001-2010. Demographics, diagnoses, and procedures data were abstracted using ICD-9 codes. We used the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSI) to identify hospital-acquired adverse events. Weighted analyses were performed using t-tests and chi-square. Results A total of 302,444 hospitalizations for lung cancer resection and were included in the analysis.

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“…Health status was assessed by utilizing the age-adjusted Charlson Comorbidity Index (CCI), which is an objective measure for assessing all-cause 10-year mortality risk and often used in research [12,13]. The age-adjusted CCI is an updated version of CCI that accounts for age and has been validated as a more accurate predictor of mortality [14]. Patients were classified as obese and morbidly obese if they had a body mass index (BMI) greater than 30 kg/m 2 and greater than 40 kg/m 2 , respectively.…”

Section: Study Variablesmentioning

confidence: 99%

Maryland’s Global Budget Revenue model associated with lower inpatient costs and 30-day readmissions in patients undergoing total hip arthroplasty

et al. 2020

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Background: Maryland implemented the Global Budget Revenue (GBR) to reduce hospital costs, improve quality, and decrease readmissions. Studies assessing its impact on inpatient total hip arthroplasty (THA) procedures are lacking. This study compared before and after GBR changes in 1) patient characteristics; 2) discharge dispositions and lengths of stay (LOS); 3) costs and charges of inpatient stays; and 4) 30-day readmission rates (RR) for THA recipients. Methods: The Maryland State Inpatient Database was queried for patients who underwent THA between 2010 and 2016 utilizing the ICD-9 and ICD-10 procedure codes (n ¼ 43,251). Pre-and post-GBR periods were grouped as 2010 to 2013 and 2014 to 2016, respectively. Chi-square analyses were used to analyze patient characteristics. Student's t-tests were utilized to compare ages, LOS, costs, charges, and RR. Results: There were no differences in the proportion of minorities undergoing THA between the pre-and post-GBR periods (18.3% vs 19.4% African American, 1.2% vs 1.3% Hispanic; P ¼ .056). The number of THA patients with Medicaid insurances increased during post-GBR (4.0% vs 6.7%; P < .001). There was an increased rate of home discharges during post-GBR (33.1% vs 40.9%; P < .001). We found lower LOS (À0.50 days; 95% CI: À0.458 to À0.

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The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices

Abstract: The operated lung cancer patients with severe comorbidities were associated with worse survival. The ACCI appears to be a more appropriate prognostic indicator and should be considered for use in clinical practice.

Cited by 94 publications

References 29 publications

Mid-term lifetime survivals of octogenarians following primary and revision total knee arthroplasties were satisfactory: a retrospective single center study in contemporary period

Mid-term lifetime survivals of octogenarians following primary and revision total knee arthroplasties were satisfactory: a retrospective single center study in contemporary period

Increased reporting but decreased mortality associated with adverse events in patients undergoing lung cancer surgery: Competing forces in an era of heightened focus on care quality?

Maryland’s Global Budget Revenue model associated with lower inpatient costs and 30-day readmissions in patients undergoing total hip arthroplasty

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