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Rashid, M, Kwok, CS, Gale, CP, Doherty, P, Olier, I, Sperrin, M, Kontopantelis, E, Peat, G and Mamas, MA (2016) Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident: a systematic review and meta-analysis. European Heart Journal Quality of Care & Clinical Outcomes, 3 (1). pp. 20-36. ISSN 2058-5225
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Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident a systematic review and meta-analysis..pdf - Published Version Download (1MB) | Preview |
Abstract
Aims: We sought to investigate the prognostic impact of co-morbid burden as defined by the Charlson Co-morbidity Index (CCI) in patients with a range of prevalent cardiovascular diseases. Methods and results: We searched MEDLINE and EMBASE to identify studies that evaluated the impact of CCI on mortality in patients with cardiovascular disease. A random-effects meta-analysis was undertaken to evaluate the impact of CCI on mortality in patients with coronary heart disease (CHD), heart failure (HF), and cerebrovascular accident (CVA). A total of 11 studies of acute coronary syndrome (ACS), 2 stable coronary disease, 5 percutaneous coronary intervention (PCI), 13 HF, and 4 CVA met the inclusion criteria. An increase in CCI score per point was significantly associated with a greater risk of mortality in patients with ACS [pooled relative risk ratio (RR) 1.33; 95% CI 1.15-1.54], PCI (RR 1.21; 95% CI 1.12-1.31), stable coronary artery disease (RR 1.38; 95% CI 1.29-1.48), and HF (RR 1.21; 95% CI 1.13-1.29), but not CVA. A CCI score of >2 significantly increased the risk of mortality in ACS (RR 2.52; 95% CI 1.58-4.04), PCI (RR 3.36; 95% CI 2.14-5.29), HF (RR 1.76; 95% CI 1.65-1.87), and CVA (RR 3.80; 95% CI 1.20-12.01). Conclusion: Increasing co-morbid burden as defined by CCI is associated with a significant increase in risk of mortality in patients with underlying CHD, HF, and CVA. CCI provides a simple way of predicting adverse outcomes in patients with cardiovascular disease and should be incorporated into decision-making processes when counselling patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Cardiovascular disease; Charlson Co-morbidity Index; Mortality |
| Subjects: | H Social Sciences > HA Statistics R Medicine > R Medicine (General) |
| Divisions: | Applied Mathematics (merged with Comp Sci 10 Aug 20) |
| Publisher: | Oxford University Press (OUP) |
| Related URLs: | |
| Date Deposited: | 24 Sep 2018 11:00 |
| Last Modified: | 04 Sep 2021 02:26 |
| DOI or ID number: | 10.1093/ehjqcco/qcw025 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/9310 |
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