You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes1 Apr 201137 IMPROVED PREDICTION OF LONG-TERM, OTHER-CAUSE MORTALITY IN MEN WITH PROSTATE CANCER Timothy Daskivich, Lorna Kwan, Karim Chamie, Jessica Labo, Atreya Dash, Sheldon Greenfield, and Mark Litwin Timothy DaskivichTimothy Daskivich Los Angeles, CA More articles by this author , Lorna KwanLorna Kwan Los Angeles, CA More articles by this author , Karim ChamieKarim Chamie Los Angeles, CA More articles by this author , Jessica LaboJessica Labo Los Angeles, CA More articles by this author , Atreya DashAtreya Dash Irvine, CA More articles by this author , Sheldon GreenfieldSheldon Greenfield Irvine, CA More articles by this author , and Mark LitwinMark Litwin Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.100AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Comorbidity assessment is essential to triage of care for men with prostate cancer. We sought to identify long-term risks of other-cause mortality associated with comorbidities in the Charlson index and apply these to creation of a prostate cancer-specific comorbidity index. METHODS We sampled 1,598 men with prostate cancer diagnosed in 1997–2004 at the Greater Los Angeles and Long Beach Veterans Affairs Medical Centers. We used a Cox proportional hazards model to determine risks of other-cause mortality associated with comorbidities and used these hazard ratios to reweigh the Charlson index. We then compared the ability of each index to predict other-cause mortality using survival analysis and multivariate logistic regression. RESULTS Cox proportional hazards modeling showed that moderate-severe liver disease, metastatic solid tumor, lymphoma, and leukemia carried the highest risk(HR>5) for other-cause mortality, followed by moderate-severe COPD, moderate-severe renal disease, dementia, hemiplegia, and congestive heart failure(2.5≤HR<3.5). In survival analysis, our revised index identified 137 men with >90% probability of other-cause mortality within 10 years; the original Charlson identified only 51. In a multivariate model, the odds of 5-year other-cause mortality for men with original Charlson scores 1, 2, 3, and 4+ were 2.9, 6.0, 9.2, and 29.8(p<0.0001), respectively, compared with 3.9, 6.2, 12.8, and 84.2(p<0.0001) for the revised index. CONCLUSIONS Reweighing the Charlson index using disease-specific risks allowed for more accurate identification of men at highest risk for other-cause mortality. Our revision of the Charlson index may be used to aid medical decision making in men with prostate cancer. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e15 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Daskivich Los Angeles, CA More articles by this author Lorna Kwan Los Angeles, CA More articles by this author Karim Chamie Los Angeles, CA More articles by this author Jessica Labo Los Angeles, CA More articles by this author Atreya Dash Irvine, CA More articles by this author Sheldon Greenfield Irvine, CA More articles by this author Mark Litwin Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...