Key result
High Charlson Comorbidity Index is not associated with increased 2-year mortality versus a low index.
Why the study?
To evaluate the role of the Charlson comorbidity index and cofactors on 2-year mortality in older patients with intertrochanteric fractures.
Does the Charlson Comorbidity Index predict 2-year mortality in older patients with intertrochanteric fractures?
Cohort (n=60)
No
Does the Charlson Comorbidity Index predict 2-year mortality in older patients with intertrochanteric fractures?
Absolute Event Rate: 86.2% vs 93.5%
p-value: p=0.343
In older patients with intertrochanteric fractures, postoperative complications and early mobilization, rather than the Charlson Comorbidity Index, are significant predictors of 2-year survival.
May not support CCI for 2-year mortality risk stratification in older intertrochanteric fracture patients; leaves open roles for complications and mobilization.
The aim of this study was to evaluate the role of Charlson comorbidities index (CCI) and cofactors on 2-year mortality in older patients with intertrochanteric fractures. 60 cases with unilateral intertrochanteric fracture were retrospectively analyzed and divided into Low-CCI group (CCI: 1-4) or high-CCI groups (CCI: 5-6). All the patients’ electronic hospital records were reviewed. The preoperative situations (demographic data, comorbidities and fracture conditions), perioperative situations (wait time, operation time, implant choice, blood loss, transfusion or not) and postoperative situations (complications, first time out of bed, function about 1-/2- week and 2-year mortality) were recorded. 51.67% were in low-CCI group and 48.33% in high-CCI group. The survival rates in low- and high-CCI group were 93.5% and 86.2 % respectively. According to the functional results of 1- or 2- week after operation, no significant difference was found (P=0.955, 0.140). Log-rank analysis showed that the main prognostic factors were blood loss, first time out of bed and complication (P<0.05). Multivariate analysis confirmed that complication and first time out of bed were significant factor on survival rate (P=0.029, 0.010). Charlson comorbidities index maybe not the indicator of 2-year mortality in older patients with intertrochanteric fractures. In order to improve the prognosis, more attentions should be paid to reduce the complications and encourage postoperative earlier excise out of bed.
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Xu et al. (2021) conducted a cohort in Intertrochanteric fractures (n=60). High Charlson Comorbidity Index (CCI 5-6) vs. Low Charlson Comorbidity Index (CCI 1-4) was evaluated on 2-year survival rate (p=0.343). A high Charlson Comorbidity Index was not significantly associated with 2-year mortality in older patients with intertrochanteric fractures compared to a low index (86.2% vs 93.5% survival, p=0.343).
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