A new method of classifying prognostic comorbidity in longitudinal studies: development and validation

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Charlson, Mary E.¹; Pompei, Peter¹; Ales, Kathy L.¹; MacKenzie, C. Ronald¹

A new method of classifying prognostic comorbidity in longitudinal studies: development and validation

J Chron Dis. January 1, 1987;40(5):373-383

©1987 Pergamon Journals Lid

Affiliations

¹Clinical Epidemiology Unit, Department of Medicine, Cornell University Medical College, 1300 York Avenue, New York, NY 10021, U.S.A.
Abstract

The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: “0”, 12% (181); “1–2”, 26% (225); “3–4”, 52% (71); and “⩾ 5”, 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: “0”, 8% (588); “1”, 25% (54); “2”, 48% (25); “ ⩾ 3”, 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank χ² = 165; p < 0.0001). In this longer follow-up, age was also a predictor of mortality (p < 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
Links

DOI: 10.1016/0021-9681(87)90171-8

PubMed: 3558716

WoS: A1987G855900002
History

Revised: 1986-09-2

Cited By (24)

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