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Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

International journal of environmental research and public health, 2018-11, Vol.15 (11), p.2532 [Peer Reviewed Journal]

2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2018 by the authors. 2018 ;ISSN: 1660-4601 ;ISSN: 1661-7827 ;EISSN: 1660-4601 ;DOI: 10.3390/ijerph15112532 ;PMID: 30424531

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  • Title:
    Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke
  • Author: Ofori-Asenso, Richard ; Zomer, Ella ; Chin, Ken Lee ; Si, Si ; Markey, Peter ; Tacey, Mark ; Curtis, Andrea J ; Zoungas, Sophia ; Liew, Danny
  • Subjects: Adults ; Chronic illnesses ; Comorbidity ; Costs ; Economic impact ; Mortality ; Older people ; Patients ; Regression
  • Is Part Of: International journal of environmental research and public health, 2018-11, Vol.15 (11), p.2532
  • Description: The burden of comorbidity among stroke patients is high. The aim of this study was to examine the effect of comorbidity on the length of stay (LOS), costs, and mortality among older adults hospitalised for acute stroke. Among 776 older adults (mean age 80.1 ± 8.3 years; 46.7% female) hospitalised for acute stroke during July 2013 to December 2015 at a tertiary hospital in Melbourne, Australia, we collected data on LOS, costs, and discharge outcomes. Comorbidity was assessed via the Charlson Comorbidity Index (CCI), where a CCI score of 0⁻1 was considered low and a CCI ≥ 2 was high. Negative binomial regression and quantile regression were applied to examine the association between CCI and LOS and cost, respectively. Survival was evaluated with the Kaplan⁻Meier and Cox regression analyses. The median LOS was 1.1 days longer for patients with high CCI than for those with low CCI. In-hospital mortality rate was 18.2% (22.1% for high CCI versus 11.8% for low CCI, < 0.0001). After controlling for confounders, high CCI was associated with longer LOS (incidence rate ratio [IRR]; 1.35, < 0.0001) and increased likelihood of in-hospital death (hazard ratio [HR]; 1.91, = 0.003). The adjusted median, 25th, and 75th percentile costs were AUD$2483 (26.1%), AUD$1446 (28.1%), and AUD$3140 (27.9%) higher for patients with high CCI than for those with low CCI. Among older adults hospitalised for acute stroke, higher global comorbidity (CCI ≥ 2) was associated adverse clinical outcomes. Measures to better manage comorbidities should be considered as part of wider strategies towards mitigating the social and economic impacts of stroke.
  • Publisher: Switzerland: MDPI AG
  • Language: English
  • Identifier: ISSN: 1660-4601
    ISSN: 1661-7827
    EISSN: 1660-4601
    DOI: 10.3390/ijerph15112532
    PMID: 30424531
  • Source: GFMER Free Medical Journals
    PubMed Central
    ProQuest Central
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