Evaluation of co-morbidity indices in patients admitted for chronic obstructive pulmonary disease.
BACKGROUND
There is limited and conflicting information on the use of co-morbidity instruments to predict mortality in patients with chronic obstructive pulmonary disease (COPD).


METHODS
We sought to test the validity of the Charlson Index and another co-morbidity instrument, the Adult co-morbidity evaluation 27 (ACE-27), in patients admitted with COPD exacerbations. Co-morbidity scores were obtained by chart review. Information on mortality was retrieved from the Social Security Death Index. We examined the predictive validity of the Charlson and the ACE-27 using survival analysis.


RESULTS
There were 112 patients eligible for the study. The ACE-27 but not the Charlson predicted survival, after adjusting for age, gender, and smoking history in Cox regression, hazard ratio (95% CI) of 1.99 (1.17-3.39).


CONCLUSIONS
This study confirms earlier findings that the Charlson Index is not a reliable predictor of mortality in patients with COPD. However, the ACE-27 appears to be useful for predicting survival in this study.
Pinckney
R G
RG
General Internal Medicine, University of Vermont, Burlington 05401, USA. richard.pinckney@vtmednet.org
O'Brien
R
R
Piccirillo
J F
JF
Littenberg
B
B
D000368:Aged; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D014707:Vermont / Q000453:epidemiology