Abstract T P326: The Utility of Charlson Comorbidity Index in Predicting Short-term Outcomes in Patients with Primary Intracerebral Hemorrhage

Abstract

Background and Purpose: The Charlson Comorbidity Index (CCI) is used to evaluate a patient's risk of in-hospital, 1-year and 10-year mortality, and has been validated in acute ischemic stroke. Previous studies have shown that CCI influences functional outcomes. We sought to evaluate the association between CCI and outcomes in patients with primary ICH presenting to our center. Methods: Patients with primary ICH admitted to our center from 2008-2013 were included. Demographic and clinical data were collected. Primary outcomes were a discharge mRS (dmRS) of 4-6, death and poor discharge disposition (any disposition other than home or inpatient rehabilitation). Crude and adjusted logistic regressions were used to evaluate the association between CCI and outcomes. Results: A total of 383 patients were identified. There were 37 (9.7%) patients with a CCI of 0 or 1, 242 (63.2%) patients with a CCI of 2-5, and 104 (27.2%) with a CCI of 6 or greater (Figure). While the continuous CCI was not significantly associated with a dmRS of 4-6 (OR 1.08, 95% CI 0.99-1.19, p=0.09), it was associated with disposition. The odds of poor disposition increased 18% with each increase in CCI (OR 1.18, 95% CI 1.08-1.28, p=0.0003). The odds of death increased 12% with each point increase in CCI (OR 1.12, 95% CI 1.02-1.23, p=0.021). After adjusting for baseline ICH score, CCI remained significantly associated with poor disposition (OR 1.13, 95% CI 1.00-1.27, p=0.042), however the association between CCI and death was not statistically significant (OR 1.05, 95% CI 0.91-1.21, p=0.52). Conclusions: In contrast to previous studies, the CCI was not associated with poor short-term functional outcome or in-hospital mortality. However, it was significantly associated with poor discharge disposition. This suggests that cumulative comorbidities only predict disposition in ICH, because the ICH score strongly impacts poor functional outcome and in-hospital mortality.