The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices

doi:10.1093/ejcts/ezx215

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Title:	The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices
Authors:	Yang, Ching-Chieh Fong, Yao Lin, Li-Ching Que, Jenny Ting, Wei-Chen Chang, Chia-Li Wu, Hsin-Min Ho, Chung-Han Wang, Jhi-Joung Huang, Chung-I
Contributors:	Chi Mei Med Ctr, Dept Radiat Oncol Natl Sun Yat Sen Univ, Inst Biomed Sci Chia Nan Univ Pharm & Sci, Dept Pharm Chi Mei Med Ctr, Dept Thorac Surg Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm E Da Canc Hosp, Dept Radiat Oncol
Keywords:	Lung cancer Surgery Charlson comorbidity index Elixhauser comorbidity index age survival
Date:	2018-01
Issue Date:	2019-11-15 15:47:13 (UTC+8)
Publisher:	OXFORD UNIV PRESS INC
Abstract:	OBJECTIVES: To compare the prognostic performance between different comorbidity assessments of survival in patients with operated lung cancer. METHODS: A total of 4508 lung cancer patients treated by surgery between 2003 and 2012 were identified through Taiwan's National Health Insurance Research Database. Information on pre-existing comorbidities prior to the cancer diagnosis was obtained and adapted to the Charlson comorbidity index, age-adjusted Charlson comorbidity index (ACCI) and Elixhauser comorbidity index scores. The influence on survival was analysed using a Cox proportional hazard model. The discriminatory ability of the comorbidity indices were evaluated using Akaike information criterion and Harrell's C-statistic. RESULTS: The mean age of the study cohort was 64.95 +/- 11.15 years, and 56.28% of the patients were male. The median follow-up time was 2.59 years, and the 3-year overall survival was 73.94%. Among these patients, 2134 (47.3%) patients received adjuvant therapy. The Charlson comorbidity index and ACCI scores correlated well with survival and higher scores were associated with an increased 3-year mortality risk (hazard ratio = 1.21, 95% confidence interval = 1.03-1.42 and hazard ratio = 1.43, 95% confidence interval = 1.08-1.90, respectively) in multivariate analysis. The ACCI scores provided better discriminatory ability with a smaller Akaike information criterion and greater Harrell's C-statistic for 3-year overall survival compared to the Charlson comorbidity index or Elixhauser comorbidity index scores. CONCLUSIONS: The operated lung cancer patients with severe comorbidities were associated with worse survival. The ACCI appears to be a more appropriate prognostic indicator and should be considered for use in clinical practice.
???metadata.dc.relation.uri???:	https://doi.org/10.1093/ejcts/ezx215
Relation:	Clinical Infectious Diseases, v.53, n.1, pp.235-240
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles [Dept. of Hospital and Health (including master's program)] Periodical Articles

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