The Charlson Comorbidity Index: can it predict the outcome in acute kidney injury?
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NEPHROLOGY - ORIGINAL ARTICLE
The Charlson Comorbidity Index: can it predict the outcome in acute kidney injury? Serkan Feyyaz Yalin1 · Alev Bakir2 · Sinan Trabulus1 · Nurhan Seyahi1 · Mehmet Riza Altiparmak1 Received: 13 January 2020 / Accepted: 7 May 2020 © Springer Nature B.V. 2020
Abstract Purpose Comorbidity has a significant impact on the health status and treatment outcome of a patient. The Charlson comorbidity index (CCI) is a frequently used scoring system, which evaluates the prognosis based on the patient’s comorbid conditions. The aim of this study was to evaluate the usefulness of CCI in predicting the mortality and renal recovery in non-critically ill patients with severe AKI. Methods A total of 530 adult patients who were referred from the emergency department and underwent intermittent urgent hemodialysis (uHD) were enrolled in the study. Personal history for comorbidities were recorded and then assessed using the CCI. Results The mean CCI score was 3.3 ± 2.6. In our multivariate analysis, higher white blood cell count was associated with mortality (p = 0.023). The other parameters including CCI score were not found to be significantly associated with mortality excluding patients with sepsis. Moreover, the CCI was not significantly useful in the discrimination of patients with complete recovery from patients who remained dependent to dialysis. Conclusions We could not find significant association between CCI and short-term hospital mortality and renal outcome. Whereas, malnutrition, inflammation and general aging may have impact on short-term mortality among patients. Keywords Acute kidney injury · Charlson comorbidity index · Hemodialysis · Outcome
Introduction Acute kidney injury (AKI) causes a sudden decline in the glomerular filtration rate (GFR). The decline in GFR causes the dysregulation of extracellular volume and electrolytes. The accumulation of metabolic waste products leads to elevation of the serum blood urea nitrogen and creatinine. Dialysis is indicated in patients with severe kidney injury. In emergency outpatient clinics, intermittent hemodialysis is the choice of dialysis modality for patients who are clinically stable. The initiation of dialysis prevents immediate death from the complications of a renal failure. However,
* Serkan Feyyaz Yalin [email protected] 1
Division of Nephrology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
Department of Biostatistics and Medical Informatics, Faculty of Health Sciences, Halic University, Istanbul, Turkey
2
mortality in patients with AKI remains high, exceeding 50%, especially in severely ill patients [1, 2]. Comorbidity has a significant impact on the health status and treatment outcome of a patient. Comorbidities such as diabetes mellitus, hypertension, connective tissue diseases, congestive heart failure, ischemic heart disease, sepsis, malignancy, chronic liver disease and cerebrovascular disease may contribute to mortality in patients with AKI.
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