Charlson index predicts thirtyday mortality in critically ill stroke patients MIMICIV retrospective study

Stroke, characterized by disrupted cerebral blood flow and neuronal damage, poses a significant risk of mortality. Using the MIMIC-IV data, we investigated the association between the Charlson Comorbidity Index (CCI) and 30-day mortality in critically ill patients with stroke. Our analysis showed that each unit increase in CCI raised mortality risk by 12% (HR = 1.12, 95% CI = 1.09-1.16, P < .001). Subgroup analysis indicated no demographic interactions (P > .05), and sensitivity analyses confirmed the robustness of the findings across the models. Systematic CCI evaluation may enhance risk stratification and clinical management in critical stroke care. This study highlights that higher CCI scores correlate with increased post-stroke mortality risk, underscoring the value of CCI in clinical risk assessment. However, these limitations include the vulnerability of the retrospective design to residual confounding and the exclusion of nutritional metrics (e.g., BMI) due to over 50% missing data. Despite these limitations, the incorporation of CCI assessments can improve the outcomes.