title: Charlson Comorbidity Index does not predict long-term mortality in elderly subjects with chronic heart failure.
abstract: BACKGROUND
  comorbidity plays a critical role in the high mortality for chronic heart failure (CHF) in the elderly. Charlson Comorbidity Index (CCI) is the most extensively studied comorbidity index. No studies are available on the ability of CCI to predict mortality in CHF elderly subjects. The aim of the present study was to assess if CCI was able to predict long-term mortality in a random sample of elderly CHF subjects.
  
  
  METHODS
  long-term mortality after 12-year follow-up in 125 subjects with CHF and 1,143 subjects without CHF was studied. Comorbidity was evaluated using CCI.
  
  
  RESULTS
  in elderly subjects stratified for CCI (1-3 and > or =4), mortality was higher in non-CHF subjects with CCI > or =4 (52.4% versus 70%, P < 0.002) but not in those with CHF (75.9% versus 77.6%, P = 0.498, NS). Cox regression analysis on 12 years mortality indicated that both CCI (HR = 1.15; 95% CI = 1.01-1.31; P = 0.035) and CHF (HR = 1.27; 95% CI = 1.04-8.83; P = 0.003) were predictive of mortality. When Cox analysis was performed by selecting the presence and the absence of CHF, CCI was predictive of mortality in the absence but not in the presence of CHF.
  
  
  CONCLUSIONS
  CCI does not predict long-term mortality in elderly subjects with CHF.
authors.affiliation: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Cattedra di Geriatria, Università degli Studi di Napoli 'Federico II', Naples, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Testa
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Galizia
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazzella
authors.forename: Salvatore
authors.initials: S
authors.lastname: Russo
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D003071:Cognition; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012720:Severity of Illness Index; D016019:Survival Analysis