title: Comparison of two comorbidity scoring systems for older adults with traumatic injuries.
abstract: BACKGROUND
  The purpose of this study was to determine the mortality predictive value of two different comorbidity scores, Comorbidity-Polypharmacy Score (CPS) and Charlson scoring system, in a large sample of older trauma patients.
  
  
  METHODS
  At an urban tertiary care Level I trauma center, trauma patients aged 55 years and older who were initially admitted to critical care were included. This retrospective chart review was conducted at Harborview Medical Center in Seattle, WA. Older trauma patients admitted from January 1, 2010 through December 31, 2010 were screened for inclusion. One-year mortality data were obtained from the Washington State Department of Health. Covariates included age, presence of hypotension, traumatic brain injury, and Injury Severity Score.
  
  
  RESULTS
  Records for 667 older trauma patients were reviewed. In multivariate analyses, CPS was an independent predictor of fatal outcomes. Higher CPS was associated with greater mortality, however, it was not superior to Charlson methodology in predicting 1-year mortality in this patient cohort.
  
  
  CONCLUSIONS
  The addition of a comorbidity score improves multivariate models predicting long-term mortality in older trauma patients. There was no advantage to using CPS instead of Charlson score, and each was an independent predictor of fatal outcomes.
authors.affiliation: Department of Pharmacy, University of Washington, Harborview Medical Center, Seattle, WA. Electronic address: holmesme@uw.edu.
authors.forename: Meredith
authors.initials: M
authors.lastname: Holmes
authors.affiliation: Department of Pharmacy, University of Washington, Harborview Medical Center, Seattle, WA.
authors.forename: Matt
authors.initials: M
authors.lastname: Garver
authors.affiliation: Dartmouth College, Hanover, NH.
authors.forename: Lily
authors.initials: L
authors.lastname: Albrecht
authors.affiliation: Department of Surgery, Division of Trauma, Burns and Critical Care, University of Washington, Harborview Medical Center, Seattle, WA.
authors.forename: Saman
authors.initials: S
authors.lastname: Arbabi
authors.affiliation: Department of Surgery, Division of Trauma, Burns and Critical Care, University of Washington, Harborview Medical Center, Seattle, WA.
authors.forename: Tam N
authors.initials: TN
authors.lastname: Pham
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*