Document Detail

Comparison of the Charlson Comorbidity Index and the Davies score as a predictor of outcomes in PD patients.
MedLine Citation:
PMID:  14703198     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Comorbidity is a strong predictor and confounds many studies of outcomes. Previous studies have shown that the Charlson Comorbidity Index (CCI) and the Davies score predict mortality in peritoneal dialysis (PD) patients. However, there are few data on the comparison of comorbidity scores. OBJECTIVE: To compare the CCI (combines comorbidity and age) and Davies score (comorbidity score without age) to see if one score was superior to the other in predicting outcomes. DESIGN: Prospective database study. SETTING: Seven dialysis centers in Western Pennsylvania. PARTICIPANTS: 415 incident PD patients, starting PD from 1/1/90 to 2/1/00. MEASUREMENTS: The CCI and Davies score calculated at the start of PD; serum albumin levels and demographics at the start of PD; total hospitalizations and mortality, collected prospectively. RESULTS: The correlation between CCI and Davies was 0.80, p < 0.0001. The CCI was inversely correlated with serum albumin (-0.31, p < 0.0001). Davies was significantly correlated with age (0.32, p < 0.0001) and inversely correlated with albumin (-0.27, p < 0.0001). The CCI alone was a stronger predictor than Davies alone (score by best subsets regression 49.6 vs 42.0, p = 0.0058). The CCI and Davies with age appeared to be equivalent models of survival (49.61 vs 49.64). The best predictive models were CCI and initial albumin, or Davies, age, and initial albumin. Both CCI and Davies were predictors of hospitalization rates, but the model with the Davies score was better (Akaike information criterion 799.2 vs 850.2). The best predictive model was Davies, albumin, age, and race. CONCLUSIONS: Both comorbidity scores were significant predictors of outcomes, with CCI the stronger predictor for mortality, but the Davies was a stronger predictor of hospitalizations. One or both should be done at the start of dialysis to predict outcome.
Linda Fried; Judith Bernardini; Beth Piraino
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  23     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:    2003 Nov-Dec
Date Detail:
Created Date:  2004-01-01     Completed Date:  2004-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  568-73     Citation Subset:  IM    
Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
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MeSH Terms
Health Status Indicators*
Hospitalization / statistics & numerical data
Middle Aged
Peritoneal Dialysis* / mortality
Prospective Studies

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