Meredith Holmes1, Matt Garver2, Lily Albrecht3, Saman Arbabi4, Tam N Pham4. 1. Department of Pharmacy, University of Washington, Harborview Medical Center, Seattle, WA. Electronic address: holmesme@uw.edu. 2. Department of Pharmacy, University of Washington, Harborview Medical Center, Seattle, WA. 3. Dartmouth College, Hanover, NH. 4. Department of Surgery, Division of Trauma, Burns and Critical Care, University of Washington, Harborview Medical Center, Seattle, WA.
Abstract
BACKGROUND: The purpose of this study was to determine the mortality predictive value of two different comorbidity scores, Comorbidity-Polypharmacy Score (CPS) and Charlson scoring system, in a large sample of older trauma patients. STUDY DESIGN: At an urban tertiary care Level I trauma center, trauma patients aged 55 years and older who were initially admitted to critical care were included. This retrospective chart review was conducted at Harborview Medical Center in Seattle, WA. Older trauma patients admitted from January 1, 2010 through December 31, 2010 were screened for inclusion. One-year mortality data were obtained from the Washington State Department of Health. Covariates included age, presence of hypotension, traumatic brain injury, and Injury Severity Score. RESULTS: Records for 667 older trauma patients were reviewed. In multivariate analyses, CPS was an independent predictor of fatal outcomes. Higher CPS was associated with greater mortality, however, it was not superior to Charlson methodology in predicting 1-year mortality in this patient cohort. CONCLUSIONS: The addition of a comorbidity score improves multivariate models predicting long-term mortality in older trauma patients. There was no advantage to using CPS instead of Charlson score, and each was an independent predictor of fatal outcomes.
BACKGROUND: The purpose of this study was to determine the mortality predictive value of two different comorbidity scores, Comorbidity-Polypharmacy Score (CPS) and Charlson scoring system, in a large sample of older traumapatients. STUDY DESIGN: At an urban tertiary care Level I trauma center, traumapatients aged 55 years and older who were initially admitted to critical care were included. This retrospective chart review was conducted at Harborview Medical Center in Seattle, WA. Older traumapatients admitted from January 1, 2010 through December 31, 2010 were screened for inclusion. One-year mortality data were obtained from the Washington State Department of Health. Covariates included age, presence of hypotension, traumatic brain injury, and Injury Severity Score. RESULTS: Records for 667 older traumapatients were reviewed. In multivariate analyses, CPS was an independent predictor of fatal outcomes. Higher CPS was associated with greater mortality, however, it was not superior to Charlson methodology in predicting 1-year mortality in this patient cohort. CONCLUSIONS: The addition of a comorbidity score improves multivariate models predicting long-term mortality in older traumapatients. There was no advantage to using CPS instead of Charlson score, and each was an independent predictor of fatal outcomes.
Authors: Barclay T Stewart; Evan Wong; Shailvi Gupta; Santosh Bastola; Sunil Shrestha; Adam L Kushner; Benedict C Nwomeh Journal: Surgery Date: 2015-05 Impact factor: 3.982
Authors: Ronnie N Mubang; Jill C Stoltzfus; Marissa S Cohen; Brian A Hoey; Christy D Stehly; David C Evans; Christian Jones; Thomas J Papadimos; Jennifer Grell; William S Hoff; Peter Thomas; James Cipolla; Stanislaw P Stawicki Journal: World J Surg Date: 2015-08 Impact factor: 3.352
Authors: Markus Gnädinger; Lilli Herzig; Alessandro Ceschi; Dieter Conen; Alfred Staehelin; Marco Zoller; Milo A Puhan Journal: Int J Public Health Date: 2018-05-21 Impact factor: 3.380
Authors: Stephen D Dingley; Wayne B Bauerle; Christine Ramirez; Holly Weber; Rebecca Wilde-Onia; Ann-Marie Szoke; Adam Benton; Danielle Frutiger; Alaa-Eldin Mira; William Hoff; Stanislaw P Stawicki Journal: J Emerg Trauma Shock Date: 2022-06-27
Authors: Stanislaw P Stawicki; Sarathi Kalra; Christian Jones; Carla F Justiniano; Thomas J Papadimos; Sagar C Galwankar; Scott M Pappada; John J Feeney; David C Evans Journal: J Emerg Trauma Shock Date: 2015 Oct-Dec