The use of Charlson comorbidity index for patients revisiting the emergency department within 72 hours.
BACKGROUND
To validate the use of the Charlson Comorbidity Index (CCI) for predicting admission of patients revisiting the Emergency Department (ED) within 72 hours.


METHODS
Non-trauma patients aged above 17 years old who revisited an urban ED within 72 hours during January of 2004 were included in this retrospective observational study. Demographic data, diagnosis, CCI, in-hospital mortality rate and length of hospital stay were reviewed, and comparisons were made between the patients who were admitted or discharged on their return visits.


RESULTS
Of the 168 enrolled patients, 60 were admitted to a ward and 108 were discharged. Revisiting patients with high CCIs (> or = 2) had a higher admission rate (67.3% vs. 22.7%; p < 0.001) and an increased adjusted odds ratio of admission (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.14-3.75) than low CCI patients. Admitted revisiting patients with high CCIs had poorer prognoses, longer hospital stays (11.79 +/- 8.92 days vs. 6.78 +/- 5.17 days; p < 0.05) and a higher in-hospital mortality rate (15.2% vs. 3.7%; p = 0.209).


CONCLUSIONS
CCI was well correlated with the admission possibility of patients revisiting the ED within 72 hours. More clinical management and discharge strategies should target those revisiting patients who have more comorbidities.
Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Han-Yi
HY
Wang
Ghee
G
Chew
Chia-Te
CT
Kung
Kun-Jung
KJ
Chung
Wen-Huei
WH
Lee
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011379:Prognosis; D012189:Retrospective Studies