RT Journal Article
T1 Comparison of a polypharmacy-based scale with Charlson comorbidity index to predict 6-month mortality in chronic complex patients after an ED visit
A1 Enríquez Gómez, Andrés
A1 Ortega Navarro, María Cristina
A1 Fernández Cordón, Clara
A1 Díez Villanueva, Pablo
A1 Martínez-Sellés D Oliveira Soares, Manuel
A1 De Lorenzo Pinto, Ana
A1 Miguel Yanes, José María De
AB Aims: The aim of this study was to test whether a newly designed polypharmacy-based scale would perform better than Charlson's Comorbidity Index (CCI) to predict outcomes in chronic complex adult patients after a reference Emergency Department (ED) visit.Methods: We built a polypharmacy-based scale with prespecified drug families. The primary outcome was 6-month mortality after the reference ED visit. Predefined secondary outcomes were need for hospital admission, 30-day readmission, and 30-day and 90-day mortality. We evaluated the ability of the CCI and the polypharmacy-based scale to independently predict 6-month mortality using logistic regression, receiver operating characteristic (ROC) curves, and cumulative survival curves using Kaplan-Meier estimates and the log-rank test for three-category distributions of the polypharmacy-based scale and the CCI. Finally, we sought to replicate our results in two different external validation cohorts.Results: We included 201 patients (53.7% women, mean age = 81.4 years), 162 of whom were admitted to the hospital at the reference ED visit. In separate multivariable analyses accounting for gender, age and main diagnosis at discharge, both the polypharmacy-based scale (P < .001) and the CCI (P = .005) independently predicted 6-month mortality. The polypharmacy-based scale performed better in the ROC analyses (area under the curve [AUC] = 0.838, 95% confidence interval [CI] = 0.780-0.896) than the CCI (AUC = 0.628, 95% CI = 0.548-0.707). In the 6-month cumulative survival analysis, the polypharmacy-based scale showed statistical significance (P < .001), whereas the CCI did not (P = .484). We replicated our results in the validation cohorts.Conclusions: Our polypharmacy-based scale performed significantly better than the CCI to predict 6-month mortality in chronic complex patients after a reference ED visit.
PB Wiley
SN 0306-5251
YR 2022
FD 2022
LK https://hdl.handle.net/20.500.14352/92958
UL https://hdl.handle.net/20.500.14352/92958
LA eng
NO Enríquez-Gómez A, Ortega-Navarro C, Fernández-Cordón C, Díez-Villanueva P, Martínez-Sellés M, de Lorenzo-Pinto A, de Miguel-Yanes JM. Comparison of a polypharmacy-based scale with Charlson comorbidity index to predict 6-month mortality in chronic complex patients after an ED visit. Br J Clin Pharmacol. 2022 Feb;88(4):1795-1803
DS Docta Complutense
RD 25 dic 2025