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Age and Ageing Advance Access originally published online on September 15, 2009
Age and Ageing 2009 38(6):734-740; doi:10.1093/ageing/afp165
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© The Author 2009. Published by Oxford University Press [on behalf of the British Geriatrics Society]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Charlson Comorbidity Index does not predict long-term mortality in elderly subjects with chronic heart failure

Gianluca Testa1,2, Francesco Cacciatore3, Gianluigi Galizia1, David Della-Morte1, Francesca Mazzella1,3, Salvatore Russo1, Nicola Ferrara3,4, Franco Rengo1,3 and Pasquale Abete1

1 Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Cattedra di Geriatria, Università degli Studi di Napoli ‘Federico II’, Naples, Italy
2 Facoltà di Scienze del Benessere, Università del Molise, Campobasso, Italy
3 Istituto Scientifico di Campoli/Telese, Fondazione Salvatore Maugeri, IRCCS, Benevento, Italy
4 Cattedra di Medicina Interna, Dipartimento di Scienze animali, vegetali ed ambientali, Università del Molise, Campobasso, Italy

Address correspondence to: P. Abete. Tel: (+39) 081 7462270; Fax: (+39) 081 7462339. Email: p.abete{at}unina.it

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.

Findings: in elderly subjects stratified for CCI (1–3 and ≥4), mortality was higher in non-CHF subjects with CCI ≥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.

Conclusion: CCI does not predict long-term mortality in elderly subjects with CHF.

Keywords: Charlson Comorbidity Index, elderly patients, mortality, heart failure, elderly

Received 22 December 2008; accepted in revised form 17 June 2009.


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