Value of age-combined Charlson co-morbidity index in predicting the prognosis of in-hospital cardiac arrest in patients with acute coronary syndrome

Abstract:

Objective：To investigate the predictive efficiency of age-combined Charlson co-morbidity index（ACCI） for the prognosis of in-hospital cardiac arrest（IHCA） in patients with acute coronary syndrome（ACS），and to provide some recommendations for prog－nostic evaluation in clinical practice. Methods：A case analysis was performed for ACS patients who experienced IHCA in three grade A tertiary hospitals in Fujian Province，China. The data on general information，comorbidities before IHCA，and prognosis were collected，and ACCI score was calculated，with 0-2 points as low risk，3-5 points as moderate risk，6-8 points as high risk，and ≥9 points as extremely high risk. The prediction efficiency of ACCI for patient prognosis was analyzed. Results：A total of 320 ACS patients who experienced IHCA were enrolled，with a hospital discharge rate of 21.2%. Median ACCI was 5（range 4-7），and there was a significant difference in ACCI between the survival group and the hospital death group（P<0.001）. Compared with the low-risk group，the moderate-risk，high-risk，and extremely high-risk groups had odds ratios for hospital discharge of 0.49（0.11-1.33），0.11（0.03-0.41）（P<0.05），and 0.15（0.30-0.77）（P<0.05），respectively. After being combined with age，Charlson co-morbidity index（CCI） had an increased area under the receiver operating characteristic curve（0.68 vs. 0.76） and an increased specificity（76% vs. 85%）. Conclusion：ACS patients with a higher ACCI tend to have poorer prognosis of IHCA. After being combined with age，CCI has im－proved predictive efficiency and increased sensitivity and speci－ficity.