Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients

Manoch Rattanasompattikul, Usama Feroze, Miklos Z. Molnar, Ramanath Dukkipati, Csaba Kovesdy, Allen R. Nissenson, Keith C. Norris, Joel D. Kopple, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

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Abstract

Purpose: The Charlson comorbidity index (CCI) is a commonly used scale for assessing morbidity, but its role in assessing mortality in hemodialysis patients is not clear. Age, a component of CCI, is a strong risk factor for morbidity and mortality in chronic diseases and correlates with comorbidities. We hypothesized that the Charlson comorbidity index without age is a strong predictor of mortality in hemodialysis patients. Methods: A 6-year cohort of 893 hemodialysis patients was examined for an association between a modified CCI (without age and kidney disease) (mCCI) and mortality. Results: Patients were 53 ± 15 years old (mean ± SD), had a median mCCI score of 2, and included 47% women, 31% African Americans and 55% diabetics. After adjusting for case-mix and nutritional and inflammatory markers including C-reactive protein and interleukin-6, 2nd (mCCI: 1-2), 3rd (mCCI = 3), and 4th (mCCI: 4-9) quartiles compared to 1st (mCCI = 0) quartiles showed death hazard ratios (95% confidence intervals) of 1.43 (0.92-2.23), 1.70 (1.06-2.72), and 2.33 (1.43-3.78), respectively. The mCCI-death association was robust in non-African Americans. The CCI-death association linearity was verified in cubic splines. Each 1 unit higher mCCI score was associated with a death hazard ratio of 1.16 (1.07-1.27). Conclusions: CCI independent of age is a robust and linear predictor of mortality in hemodialysis patients, in particular in non-African Americans.

Original languageEnglish (US)
Pages (from-to)1813-1823
Number of pages11
JournalInternational Urology and Nephrology
Volume44
Issue number6
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

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Renal Dialysis
Comorbidity
Mortality
Morbidity
Diagnosis-Related Groups
Kidney Diseases
African Americans
C-Reactive Protein
Interleukin-6
Chronic Disease
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

Cite this

Rattanasompattikul, M., Feroze, U., Molnar, M. Z., Dukkipati, R., Kovesdy, C., Nissenson, A. R., ... Kalantar-Zadeh, K. (2012). Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients. International Urology and Nephrology, 44(6), 1813-1823. https://doi.org/10.1007/s11255-011-0085-9

Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients. / Rattanasompattikul, Manoch; Feroze, Usama; Molnar, Miklos Z.; Dukkipati, Ramanath; Kovesdy, Csaba; Nissenson, Allen R.; Norris, Keith C.; Kopple, Joel D.; Kalantar-Zadeh, Kamyar.

In: International Urology and Nephrology, Vol. 44, No. 6, 01.12.2012, p. 1813-1823.

Research output: Contribution to journalArticle

Rattanasompattikul, M, Feroze, U, Molnar, MZ, Dukkipati, R, Kovesdy, C, Nissenson, AR, Norris, KC, Kopple, JD & Kalantar-Zadeh, K 2012, 'Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients', International Urology and Nephrology, vol. 44, no. 6, pp. 1813-1823. https://doi.org/10.1007/s11255-011-0085-9
Rattanasompattikul, Manoch ; Feroze, Usama ; Molnar, Miklos Z. ; Dukkipati, Ramanath ; Kovesdy, Csaba ; Nissenson, Allen R. ; Norris, Keith C. ; Kopple, Joel D. ; Kalantar-Zadeh, Kamyar. / Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients. In: International Urology and Nephrology. 2012 ; Vol. 44, No. 6. pp. 1813-1823.
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abstract = "Purpose: The Charlson comorbidity index (CCI) is a commonly used scale for assessing morbidity, but its role in assessing mortality in hemodialysis patients is not clear. Age, a component of CCI, is a strong risk factor for morbidity and mortality in chronic diseases and correlates with comorbidities. We hypothesized that the Charlson comorbidity index without age is a strong predictor of mortality in hemodialysis patients. Methods: A 6-year cohort of 893 hemodialysis patients was examined for an association between a modified CCI (without age and kidney disease) (mCCI) and mortality. Results: Patients were 53 ± 15 years old (mean ± SD), had a median mCCI score of 2, and included 47{\%} women, 31{\%} African Americans and 55{\%} diabetics. After adjusting for case-mix and nutritional and inflammatory markers including C-reactive protein and interleukin-6, 2nd (mCCI: 1-2), 3rd (mCCI = 3), and 4th (mCCI: 4-9) quartiles compared to 1st (mCCI = 0) quartiles showed death hazard ratios (95{\%} confidence intervals) of 1.43 (0.92-2.23), 1.70 (1.06-2.72), and 2.33 (1.43-3.78), respectively. The mCCI-death association was robust in non-African Americans. The CCI-death association linearity was verified in cubic splines. Each 1 unit higher mCCI score was associated with a death hazard ratio of 1.16 (1.07-1.27). Conclusions: CCI independent of age is a robust and linear predictor of mortality in hemodialysis patients, in particular in non-African Americans.",
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T1 - Charlson comorbidity score is a strong predictor of mortality in hemodialysis patients

AU - Rattanasompattikul, Manoch

AU - Feroze, Usama

AU - Molnar, Miklos Z.

AU - Dukkipati, Ramanath

AU - Kovesdy, Csaba

AU - Nissenson, Allen R.

AU - Norris, Keith C.

AU - Kopple, Joel D.

AU - Kalantar-Zadeh, Kamyar

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Purpose: The Charlson comorbidity index (CCI) is a commonly used scale for assessing morbidity, but its role in assessing mortality in hemodialysis patients is not clear. Age, a component of CCI, is a strong risk factor for morbidity and mortality in chronic diseases and correlates with comorbidities. We hypothesized that the Charlson comorbidity index without age is a strong predictor of mortality in hemodialysis patients. Methods: A 6-year cohort of 893 hemodialysis patients was examined for an association between a modified CCI (without age and kidney disease) (mCCI) and mortality. Results: Patients were 53 ± 15 years old (mean ± SD), had a median mCCI score of 2, and included 47% women, 31% African Americans and 55% diabetics. After adjusting for case-mix and nutritional and inflammatory markers including C-reactive protein and interleukin-6, 2nd (mCCI: 1-2), 3rd (mCCI = 3), and 4th (mCCI: 4-9) quartiles compared to 1st (mCCI = 0) quartiles showed death hazard ratios (95% confidence intervals) of 1.43 (0.92-2.23), 1.70 (1.06-2.72), and 2.33 (1.43-3.78), respectively. The mCCI-death association was robust in non-African Americans. The CCI-death association linearity was verified in cubic splines. Each 1 unit higher mCCI score was associated with a death hazard ratio of 1.16 (1.07-1.27). Conclusions: CCI independent of age is a robust and linear predictor of mortality in hemodialysis patients, in particular in non-African Americans.

AB - Purpose: The Charlson comorbidity index (CCI) is a commonly used scale for assessing morbidity, but its role in assessing mortality in hemodialysis patients is not clear. Age, a component of CCI, is a strong risk factor for morbidity and mortality in chronic diseases and correlates with comorbidities. We hypothesized that the Charlson comorbidity index without age is a strong predictor of mortality in hemodialysis patients. Methods: A 6-year cohort of 893 hemodialysis patients was examined for an association between a modified CCI (without age and kidney disease) (mCCI) and mortality. Results: Patients were 53 ± 15 years old (mean ± SD), had a median mCCI score of 2, and included 47% women, 31% African Americans and 55% diabetics. After adjusting for case-mix and nutritional and inflammatory markers including C-reactive protein and interleukin-6, 2nd (mCCI: 1-2), 3rd (mCCI = 3), and 4th (mCCI: 4-9) quartiles compared to 1st (mCCI = 0) quartiles showed death hazard ratios (95% confidence intervals) of 1.43 (0.92-2.23), 1.70 (1.06-2.72), and 2.33 (1.43-3.78), respectively. The mCCI-death association was robust in non-African Americans. The CCI-death association linearity was verified in cubic splines. Each 1 unit higher mCCI score was associated with a death hazard ratio of 1.16 (1.07-1.27). Conclusions: CCI independent of age is a robust and linear predictor of mortality in hemodialysis patients, in particular in non-African Americans.

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