title: The value of the Charlson Co-morbidity Index in aneurysmal subarachnoid haemorrhage.
abstract: BACKGROUND
  Several studies have included different co-morbid conditions in prediction models for stroke patients. For subarachnoid haemorrhage (SAH), it is not known whether the Charlson Co-morbidity Index (CCI) is associated with outcome. We evaluated if this index was associated with outcome in patients with ruptured intracerebral aneurysms.
  
  
  METHODS
  The data of all consecutive aneurysmal SAH (aSAH) patients treated at the Radboudumc, Nijmegen, The Netherlands and entered in the database were retrospectively analysed. Clinical condition at admission was recorded using the WFNS (World Federation of Neurological Surgeons Grading System) grade was collected, as were the age and treatment modality. The burden of co-morbidity was retrospectively registered using the CCI. Outcome was dichotomised on the modified Rankin Scale (mRS; 0-2, favourable outcome; 3-6, unfavourable outcome). A binary logistic regression analysis was performed.
  
  
  RESULTS
  Between 6th May 2008 and 31st July 2013, 457 patients were admitted because of non-traumatic SAH (aSAH). Seventy-seven (16.8 %) patients had no aneurysm. Of the 380 patients with aSAH, information on co-morbid conditions was available for 371 patients. Thirty-six of those 371 had no treatment because of: bad clinical condition in 34 (9.2 %), a non-treatable dissecting aneurysm in 1 (0.3 %) and the explicit wishes of another. Co-morbidity was present in 113 (31.5 %) patients. Binary logistic regression analysis revealed no added value of using the CCI in predicting the outcome (p = 0.91).
  
  
  CONCLUSIONS
  This study reports that the CCI is not associated with the outcome classified on the mRS at 6 months in patients after aSAH. The CCI has no added value in case-mix correction.
authors: Department of Neurosurgery, Radboudumc, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands, Jeroen.Boogaarts@Radboudumc.nl.
authors: Hieronymus D
authors: HD
authors: Boogaarts
authors: Mariana P Duarte
authors: MP
authors: Conde
authors: Edith
authors: E
authors: Janssen
authors: Willemijn F M
authors: WF
authors: van Nuenen
authors: Joost
authors: J
authors: de Vries
authors: Rogier
authors: R
authors: Donders
authors: Gert P
authors: GP
authors: Westert
authors: J André
authors: JA
authors: Grotenhuis
authors: Ronald H M A
authors: RH
authors: Bartels
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome