Cadernos de Saúde Pública
On-line version ISSN 1678-4464
SOUZA, Rômulo Cristovão de; PINHEIRO, Rejane Sobrino; COELI, Cláudia Medina and CAMARGO JR., Kenneth Rochel de. The Charlson comorbidity index (CCI) for adjustment of hip fracture mortality in the elderly: analysis of the importance of recording secondary diagnoses . Cad. Saúde Pública [online]. 2008, vol.24, n.2, pp.315-322. ISSN 1678-4464. http://dx.doi.org/10.1590/S0102-311X2008000200010.
This study evaluates the role of the number of secondary diagnoses for calculating the Charlson comorbidity index (CCI) in risk adjustment of the 90-day mortality rate after hip fracture surgical repair. Comorbidities were selected by reviewing the medical records of 390 patients 50 years of age or older in a teaching hospital in Rio de Janeiro from 1995 to 2000. Logistic regression models were fitted including the variables age, sex, and CCI. The CCI was calculated based on: (1) all patients' comorbidities; (2) only the comorbidity with the highest weight; and (3) a single randomly selected comorbidity. There was a gradient in the prediction of the CCI mortality rate when all comorbidities were used (OR = 6.53; 95%CI: 2.27-18.77, for scores ³ 3). The predictive capacity of the CCI was observed even when it was calculated using only one comorbidity: with the highest weight (OR = 2.83; 95%CI: 1.11-7.22); and randomly selected (OR = 2.90; 95%CI: 1.07-7.81). Using all comorbidities for CCI calculation is important. Severity indices based on a single comorbidity can be useful for risk adjustment procedures.
Keywords : Femoral Fractures; Comorbidity; Mortality.