4.5 Article

Charlson's weighted index of comorbidities is useful in assessing the risk of death in septic patients

Journal

JOURNAL OF CRITICAL CARE
Volume 27, Issue 4, Pages 370-375

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2011.08.021

Keywords

Sepsis; Comorbidities; Charlson's WIC; Prognostic

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Purpose: We investigated the efficiency of the Charlson's weighted index of comorbidities (WIC) in predicting the risk of death in septic patients. Materials and Methods: A single-center, 3-year analysis of all septic patients was conducted; WIC and organ failure assessed using the Sepsis-related Organ Failure Assessment (SOFA) score were calculated retrospectively. Results: Of 250 septic patients, 60 patients (34%) had WIC above 2. Fifty-five patients (22%) died during the hospitalization. Increasing WIC was associated with increased mortality. Mean WIC differed significantly between survivors and nonsurvivors (P < .0001), and the univariate logistic regression revealed that risk of death depends significantly of WIC with odds ratio of 1.59 (95% confidence interval, 1.31-1.93; P < .001). The accuracy of prediction for the risk of death was 79.2%. Receiver operating characteristics curve indicated a WIC of 2 as a cutoff value, the association between WIC greater than 2, and the risk of death being described by an odds ratio of 1.87 (95% confidence interval, 1.017-3.457; P = .042); the area under the receiver operating characteristics curve in predicting mortality was 0.81 for the SOFA score and 0.68 for WIC; WIC correlated positively with SOFA (r = 0.27; P < .0001). Conclusion: In septic patients, WIC is predictive for hospital mortality, and the risk of death significantly depends on WIC. (C) 2012 Elsevier Inc. All rights reserved.

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