title: Predictive value of the Charlson comorbidity index in kidney transplantation.
abstract: BACKGROUND
  Nonimmunologic factors have been recently implicated in worse outcomes after kidney transplantation, producing a need to predict the operative risk among kidney recipients. We assessed the predictive value of the Charlson comorbidity index (CCI) among kidney transplant recipients.
  
  
  METHODS
  A retrospective study of 223 first deceased-donor kidney transplantations performed from 2000 to 2007 evaluated the role of comorbidities.
  
  
  RESULTS
  About 50% of recipients displayed >1 comorbid condition before transplantation; the most frequently reported was diabetes mellitus. Increasing CCI scores significantly affected graft and patient survivals. Crude analysis showed a significant association between CCI >1 and risk of death (hazard ratio [HR], 3.87; 95% confidence interval [CI], 1.06-14.06; P = .04). After adjustment for several covariates, high CCI values remained significantly predictive of posttransplantation outcomes with a HR for death of (12.53; 95% CI, 1.9-82.68; P = .009).
  
  
  CONCLUSIONS
  Our predictive model showed a strong association of CCI and patient survival even after adjustment for several clinical covariates. CCI may be used to evaluate patients referred for kidney transplantation who display a significant burden of comorbid conditions that increase the risk of premature death or graft loss.
authors.affiliation: Department G.F. Ingrassia, Section of Hygiene and Public Health, University Hospital of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Grosso
authors.forename: D
authors.initials: D
authors.lastname: Corona
authors.forename: A
authors.initials: A
authors.lastname: Mistretta
authors.forename: D
authors.initials: D
authors.lastname: Zerbo
authors.forename: N
authors.initials: N
authors.lastname: Sinagra
authors.forename: A
authors.initials: A
authors.lastname: Giaquinta
authors.forename: T
authors.initials: T
authors.lastname: Tallarita
authors.forename: B
authors.initials: B
authors.lastname: Ekser
authors.forename: A
authors.initials: A
authors.lastname: Leonardi
authors.forename: R
authors.initials: R
authors.lastname: Gula
authors.forename: P
authors.initials: P
authors.lastname: Veroux
authors.forename: M
authors.initials: M
authors.lastname: Veroux
mesh_terms: D015897:Comorbidity; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome