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Renaissance of Modified Charlson Comorbidity Index in Prediction of Short- and Long-Term Survival After Liver Transplantation?
- Source :
-
Medical science monitor : international medical journal of experimental and clinical research [Med Sci Monit] 2019 Jun 18; Vol. 25, pp. 4521-4526. Date of Electronic Publication: 2019 Jun 18. - Publication Year :
- 2019
-
Abstract
- BACKGROUND Orthotopic liver transplantation (OLT) is the standard of care for end-stage liver disease. The Charlson Comorbidity Index (CCI) was originally created to assess the survival rate of patients with chronic diseases, although it was modified and adopted in OLT recipients as CCI-OLT. MATERIAL AND METHODS In total of 248 consecutive liver transplant recipients with viral cirrhosis in 98 (39.5%) patients were included. CCI-OLT was calculated assigning a weight of 3 to chronic obstructive pulmonary disease; weight of 2 to coronary artery disease, connective tissue disease, and renal insufficiency; and a weight of 1 to diabetes mellitus. RESULTS CCI-OLT was significantly correlated with recipient age (p<0.001; R=0.333) and was a significant risk factor for early post-transplant mortality (p=0.004). The presence of diabetes mellitus significantly increased the odds of early mortality (p=0.010). The optimal cut-off for CCI-OLT in prediction of mortality during the first 90 days after transplantation was ≥1, with an AUROC of 0.780 (95% CI: 0.670-0.891; p<0.001). Increasing CCI-OLT was a significant risk factor for worse 5-year post-transplant survival (p=0.001), along with coronary artery disease (p=0.008) and diabetes mellitus (p=0.021). The optimal cut-off for prediction of 5-year mortality for CCI-OLT was ≥1, with the AUROC of 0.638 (95% CI: 0.544-0.733; p=0.004). CONCLUSIONS CCI-OLT is a useful tool for measuring the effect of pretransplant comorbidities and to stratify the effect of risk on both short- and long-term outcomes after OLT. Recipient age and diabetes strongly affected short-term survival after OLT, and metabolic and vascular complications were the leading causes of death at 5 years after OLT.
- Subjects :
- Adult
Aged
Chronic Disease
Comorbidity
Connective Tissue Diseases complications
Coronary Disease complications
Diabetes Mellitus
End Stage Liver Disease complications
Female
Graft Survival
Humans
Liver Cirrhosis complications
Liver Transplantation adverse effects
Male
Middle Aged
Poland
Pulmonary Disease, Chronic Obstructive
Renal Insufficiency complications
Risk Factors
Survival Rate
Treatment Outcome
End Stage Liver Disease mortality
Liver Transplantation mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1643-3750
- Volume :
- 25
- Database :
- MEDLINE
- Journal :
- Medical science monitor : international medical journal of experimental and clinical research
- Publication Type :
- Academic Journal
- Accession number :
- 31209196
- Full Text :
- https://doi.org/10.12659/MSM.914669