The Efficacy of the Charlson Comorbidity Index and Its Age-Adjusted Version in Forecasting Mortality and Postoperative Outcomes Following Isolated Coronary Artery Bypass Grafting
Ozgur Baris, Gözde Öksüzler Kizilbay, Canbolat Mert Holat, Mustafa Egemen Uzturk, Mustafa Canikoğlu, Ayşegül Durmaz, Oğuz Omay, Şadan Yavuz
Abstract
Background/Objectives: The Charlson Comorbidity Index (CCI) is designed for evaluating comorbidities and mortality risks, with the age-adjusted CCI (ACCI) combining age and comorbidity assessments. Despite its long-standing use, research on CCI’s application in cardiac surgery patients is limited. This study assessed the effectiveness of CCI and ACCI in predicting in-hospital mortality and post-surgery outcomes for patients undergoing isolated coronary artery bypass grafting (CABG). Methods: CCI and ACCI scores were derived from medical records between 2016 and 2022. Patient demographics, surgical techniques, and postoperative complications were documented. Results: Totally 393 patients [297 (75.6%) males, 96 (24.4%) females] with an average age of 65 years were included. Median CCI and ACCI scores were 1 (1–2) and 4 (3–5), respectively. In-hospital mortality occurred in 5.9% (n = 23) of cases, with CCI being an independent predictor (OR 1.865, 95% CI 1.117–3.116; p = 0.017). Both CCI and ACCI scores negatively correlated with preoperative EF (%) and positively correlated with ICU and total hospital stay, cardiopulmonary bypass time, and cross-clamp time. ACCI score also positively correlated with extubation time. Patients categorized by CCI comorbidity severity (no comorbidity, mild, moderate, severe) showed a significant increase in postoperative complications with increasing severity, including postoperative VT (p = 0.000), acute renal failure (p = 0.009), pneumonia (p = 0.007), and in-hospital mortality (p = 0.001). Conclusions: Both CCI and ACCI are prognostic indicators for in-hospital mortality in isolated CABG surgery patients, effectively predicting postoperative complications, extended ICU stays, and prolonged hospital stays. Implementing these scoring systems could enhance patient care and improve surgical decision-making.