Dados do Trabalho

Título

The Burden of Comorbidities: Assessing the Impact of the Charlson Comorbidity Index on Septic Patients in a Private ICU

Objetivo

To evaluate the impact of pre-existing comorbidities on the outcomes of sepsis patients admitted to an ICU in a private tertiary hospital in João Pessoa.

Métodos

This retrospective cohort study analyzed sepsis patients admitted to the ICU in 2023. The Charlson Comorbidity Index (CCI) was used to assess comorbidities.

Resultados

A total of 337 patients were included, with a median CCI of 1 (0-3). The most common comorbidities were hypertension (57.9%), diabetes mellitus (30%), heart failure (29.9%), and dementia (23.7%). Patients who died had a higher prevalence of diabetes (21.4% vs. 13.3%, p=0.023), heart failure (21.4% vs. 17.5%, p=0.002), stroke (7.8% vs. 3.6%, p<0.001), neoplasia (7.1% vs. 3.6%, p<0.001), and dementia (32.1% vs. 23%, p=0.05), with a significantly higher CCI of 4.5 (2-7) compared to 1 (0-3), p<0.001. While individual comorbidities did not significantly affect mortality risk, each 1-point increase in CCI was associated with a 33% higher mortality risk (OR 1.330, 95% CI 1.180-1.500). The area under the ROC curve for CCI was 0.76 (95% CI 0.669-0.851, p<0.001). The median age was 72 years, and ICU mortality was 8.3%.

Conclusão

A higher number of comorbidities, as reflected by the CCI, was associated with increased mortality in septic ICU patients. Although individual comorbidities did not significantly alter the risk of death, the overall comorbidity burden, as measured by CCI, demonstrated a substantial impact on patient outcomes, highlighting its value as a prognostic tool.