The Association Between Charlson Comorbidity Index in Different Comorbidities and ICU Admission in Patients with Aortic Aneurysm

Abstract

Background

To investigate the association between Charlson comorbidity index (CCI) and Intensive care unit (ICU) admission in subgroup aortic aneurysm (AA) patients with different comorbidities.

Methods

Patient data (N = 996) was collected from the MIMIC-IV database. The relationship between CCI and ICU admission was analyzed by logistic regression analysis. The receiver operating characteristic curve (ROC) and decision curve analysis (DCA) were used to analyze the prediction efficacy and clinical benefits of CCI. CCI-based models were also established to assess the improvement.

Results

There were significant differences in age, AA types, rupture, surgery, obesity, and smoking between patients with and without admitting to ICU (all P < 0.05). Among 18 comorbidities, CCI was independently associated with ICU admission mainly reflected in patients with comorbidities of hypertension, coronary heart disease, hyperlipidemia, and congestive heart failure (all P < 0.05). However, singe CCI had limited prediction performance (AUC all less than 0.7) and clinical net benefit in any comorbidities. Combining with other independent factors of ICU admission in 4 key comorbidities specifically, CCI-based models significantly improved the prediction performance and increased clinical net benefit than single CCI. Especially, CCI-based model had the best predictive performance in patients with comorbidity of hypertension (AUC = 0.752).

Conclusions

CCI is independently associated with ICU admission in AA patients, with enhanced predictive value when combined with other clinical factors, particularly in those with hypertension.