Validation of a combined comorbidity index

Charlson, Mary E.; Szatrowski, Ted P.; Peterson, Janey C.; Gold, Jeffrey P.

doi:10.1016/0895-4356(94)90129-5

Cited by 5,704 publications

(4,030 citation statements)

References 5 publications

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“…We measured several baseline covariates that could potentially confound the relationship between statin use and adverse cardiovascular events, including age, sex, rural residence, neighborhood income quintile (as a measure for socioeconomic status),22 overall comorbidity burden (as indicated by the Charlson Comorbidity Index),23 and health services utilization. We also used a 5‐year look‐back window to establish medical comorbidities and prior cardiovascular procedures and a 1‐year look‐back window to establish baseline medication use.…”

Section: Methodsmentioning

confidence: 99%

Association Between Statin Use and Cardiovascular Events After Carotid Artery Revascularization

Hussain

Saposnik

Raju

et al. 2018

JAHA

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BackgroundStatins are commonly used for the prevention of cardiovascular events; however, statins are underutilized in patients with noncoronary atherosclerosis. We sought to establish the rates of statin use in patients with carotid artery disease and to examine the association between statin therapy and outcomes after carotid revascularization.Methods and ResultsIn this population‐level retrospective cohort study, we identified all individuals aged ≥66 years who underwent carotid endarterectomy or stenting in Ontario, Canada (2002–2014). The primary outcome was a composite of 1‐year stroke, myocardial infarction, or death (major adverse cardiac and cerebrovascular events). Five‐year risks were also examined. Adjusted hazard ratios were computed using inverse probability of treatment weighting based on propensity scores. A total of 7893 of 10 723 patients (73.6%) who underwent carotid revascularization were on preprocedural statin therapy; moderate‐ or high‐dose therapy was utilized by 7384 patients (68.9%). The composite rate of 1‐year major adverse cardiac and cerebrovascular events was lower among statin users (adjusted hazard ratio: 0.76; 95% confidence interval, 0.70–0.83). Patients who were on persistent long‐term statin therapy after the carotid procedure continued to experience significantly lower risk of major adverse cardiac and cerebrovascular events at 5 years (adjusted hazard ratio: 0.75, 95% confidence interval, 0.71–0.80). The beneficial associations with statin use were observed regardless of type of carotid revascularization procedure, carotid artery symptom status, or statin dose.ConclusionsContinuous statin therapy was associated with a 25% lower risk of long‐term adverse cardiovascular events in patients with significant carotid disease. Along with other supportive evidence, statins should be considered in patients undergoing carotid revascularization, and efforts are required to increase statin use in this undertreated population.

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Section: Methodsmentioning

confidence: 99%

Association Between Statin Use and Cardiovascular Events After Carotid Artery Revascularization

Hussain

Saposnik

Raju

et al. 2018

JAHA

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“…Clinical and demographic data was collected and CHA 2 DS 2 VASc, CHADS 2 , HAS‐BLED, Charlson comorbidity index (CCI), and SAMe‐TT₂R scores calculated 26, 27, 28, 29, 30. As the HAS‐BLED scoring system for determining bleeding risk allocates 1 point for TTR <60% which is also the grouping variable, true HAS‐BLED and adjusted HAS‐BLED scores were calculated, where the adjusted HAS‐BLED score discounts the point allocated for TTR <60%.…”

Section: Methodsmentioning

confidence: 99%

Associations between illness beliefs, medication beliefs, anticoagulation‐related quality of life, and INR control: Insights from the Switching Study

Bartoli-Abdou

Patel

Xie

et al. 2018

Research and Practice in Thrombosis and Haemostasis

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BackgroundAnticoagulation control with vitamin‐K antagonists (VKAs) in patients with atrial fibrillation (AF) or venous thromboembolism (VTE) can be measured using time in therapeutic range (TTR), where TTR >65% is considered good and low TTR may be associated with low adherence.MethodsThis cross‐sectional observational study compared illness beliefs, treatment beliefs, and treatment satisfaction of patients with TTR >75% and TTR <50% using validated tools to determine their association with TTR. Adults requiring chronic VKA therapy were recruited from 2 hospital anticoagulation clinics in London, UK.Results311 patients with TTR >75% and 214 with TTR <50% were recruited. TTR >75% patients had been taking warfarin on average over 2 years longer than TTR <50% patients (P < .001). Statistically significant differences in beliefs were found in all subscales other than in treatment control, general harm, and general overuse. Cluster analysis determined there were 4 distinct clusters of beliefs among patients. Multivariate binary logistic regression found VTE patients were least likely to have poor TTR (OR = 0.49; 95% CI 0.29, 0.77). Patients in the “cautious of therapy and fearful of illness” cluster were most likely to have low TTR (OR = 4.75; 95% CI 2.75, 8.77).ConclusionIllness perceptions, medication beliefs and treatment satisfaction were associated with INR control. VTE patients and those who were accepting of both illness and treatment were most likely to have optimal INR control.

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“…General health characteristics included body mass index (BMI) calculated from the reported height and weight, cigarette smoking history, frequency of alcohol use and days of exercise in the past month. The Charlson comorbidity index (CCI) was calculated from self‐reported physician diagnoses of comorbid conditions to represent the level of comorbidity among the respondents 29. Higher total index scores indicated a greater comorbidity burden in these patients.…”

Section: Methodsmentioning

confidence: 99%

Burden of chronic urticaria relative to psoriasis in five European countries

Balp

Khalil

Tian

et al. 2017

Acad Dermatol Venereol

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BackgroundQuantification of burden of chronic spontaneous urticaria (CSU) vs. psoriasis (PsO) is limited.ObjectiveTo evaluate the burden associated with CSU vs. PsO of all severities (overall PsO), mild and moderate/severe PsO.MethodsThis retrospective cross‐sectional analysis compared data from adult patients with chronic urticaria (CU), used as a proxy for CSU, and PsO from the National Health and Wellness Survey in France, Germany, Italy, Spain and the United Kingdom. Outcomes included mental and physical component summary scores (MCS and PCS) calculated from the Short Form (SF)‐36v2 or SF‐12v2, SF‐6D health utility scores, self‐reported psychological complaints (anxiety, depression and sleep difficulties), work productivity and activity impairment, and self‐reported healthcare resource utilization. Bivariate and multivariate analyses for each outcome and comparative groups were conducted.ResultsThis analysis included 769 CU and 7857 PsO (26.9% moderate/severe) patients. Following adjustment for covariates, CU patients showed a greater health‐related quality of life (HRQoL) impairment vs. overall PsO (MCS: −2.4, PCS: −1.6, SF‐6D: −0.03; all P < 0.001). CU patients showed a higher risk of anxiety, depression and sleep difficulties [odds ratio (OR): 1.63, 1.34 and 1.56, respectively; all P < 0.01] and greater healthcare resource use vs. overall PsO. The overall activity impairment was significantly greater in CU patients than in overall PsO patients (P = 0.001), while the impact on work was not significantly different. The results vs. moderate/severe PsO group showed no significant differences on all outcomes.ConclusionBurden of illness in CU is higher than PsO of all severities but similar to that observed in moderate/severe PsO. Both diseases have a similar negative impact on work productivity.

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Validation of a combined comorbidity index

Cited by 5,704 publications

References 5 publications

Association Between Statin Use and Cardiovascular Events After Carotid Artery Revascularization

Association Between Statin Use and Cardiovascular Events After Carotid Artery Revascularization

Associations between illness beliefs, medication beliefs, anticoagulation‐related quality of life, and INR control: Insights from the Switching Study

Burden of chronic urticaria relative to psoriasis in five European countries

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