S Tal1, V Guller, Y Shavit, F Stern, S Malnick. 1. Geriatric Medicine Department, Kaplan Medical Center, P.O. Box 1, Rehovot 76100, Israel. mail@tal.org.il
Abstract
AIM: To find out which of the two predictors, Charlson co-morbidity index or vitamin B12, better estimates the risk of in-hospital mortality in seriously ill patients. METHOD: Electronic hospital records of 1509 elderly patients aged 65 and older were retrospectively surveyed. RESULTS: Albumin, age and elevated vitamin B12 levels were significantly associated with increased in-hospital mortality. Charlson co-morbidity index was not significantly associated with death. The highest mortality (24.3%) was found in the group of patients who were concomitantly in the lowest albumin quartile and the highest vitamin B12 levels quartile. In this group, mortality increased significantly with age. By elasticity calculation, vitamin B12 capability to predict mortality was higher by ≈ 3 times than that of Charlson co-morbidity index. CONCLUSION: In view of the fact that vitamin B12 levels have been found to predict mortality, they should be measured in geriatric practice, in addition to albumin levels, as a practical and reliable tool for identifying high risk elderly hospitalized patients. Probably, a combination of two or more available and inexpensive routinely taken tests can give a better estimation of mortality than some complicated tools, like Charlson co-morbidity index.
AIM: To find out which of the two predictors, Charlson co-morbidity index or vitamin B12, better estimates the risk of in-hospital mortality in seriously ill patients. METHOD: Electronic hospital records of 1509 elderly patients aged 65 and older were retrospectively surveyed. RESULTS:Albumin, age and elevated vitamin B12 levels were significantly associated with increased in-hospital mortality. Charlson co-morbidity index was not significantly associated with death. The highest mortality (24.3%) was found in the group of patients who were concomitantly in the lowest albumin quartile and the highest vitamin B12 levels quartile. In this group, mortality increased significantly with age. By elasticity calculation, vitamin B12 capability to predict mortality was higher by ≈ 3 times than that of Charlson co-morbidity index. CONCLUSION: In view of the fact that vitamin B12 levels have been found to predict mortality, they should be measured in geriatric practice, in addition to albumin levels, as a practical and reliable tool for identifying high risk elderly hospitalized patients. Probably, a combination of two or more available and inexpensive routinely taken tests can give a better estimation of mortality than some complicated tools, like Charlson co-morbidity index.
Authors: Luise Adam; Elisavet Moutzouri; Christine Baumgartner; Axel Lennart Loewe; Martin Feller; Khadija M'Rabet-Bensalah; Nathalie Schwab; Stefanie Hossmann; Claudio Schneider; Sabrina Jegerlehner; Carmen Floriani; Andreas Limacher; Katharina Tabea Jungo; Corlina Johanna Alida Huibers; Sven Streit; Matthias Schwenkglenks; Marco Spruit; Anette Van Dorland; Jacques Donzé; Patricia M Kearney; Peter Jüni; Drahomir Aujesky; Paul Jansen; Benoit Boland; Olivia Dalleur; Stephen Byrne; Wilma Knol; Anne Spinewine; Denis O'Mahony; Sven Trelle; Nicolas Rodondi Journal: BMJ Open Date: 2019-06-03 Impact factor: 2.692