Comorbidity index for predicting mortality at 6 months after reperfusion therapy

• Main Authors: Hyo Suk Nam, Young Dae Kim, Joonsang Yoo, Hyungjong Park, Byung Moon Kim, Oh Young Bang, Hyeon Chang Kim, Euna Han, Dong Joon Kim, Joonyung Heo, Minyoung Kim, Jin Kyo Choi, Kyung-Yul Lee, Hye Sun Lee, Dong Hoon Shin, Hye-Yeon Choi, Sung-Il Sohn, Jeong-Ho Hong, Jong Yun Lee, Jang-Hyun Baek, Gyu Sik Kim, Woo-Keun Seo, Jong-Won Chung, Seo Hyun Kim, Tae-Jin Song, Sang Won Han, Joong Hyun Park, Jinkwon Kim, Yo Han Jung, Han-Jin Cho, Seong Hwan Ahn, Sung Ik Lee, Kwon-Duk Seo, Ji Hoe Heo
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-03-01
• Series: Scientific Reports
• Online Access: https://doi.org/10.1038/s41598-021-85390-4

Abstract The eligibility of reperfusion therapy has been expanded to increase the number of patients. However, it remains unclear the reperfusion therapy will be beneficial in stroke patients with various comorbidities. We developed a reperfusion comorbidity index for predicting 6-month mortality in patients with acute stroke receiving reperfusion therapy. The 19 comorbidities included in the Charlson comorbidity index were adopted and modified. We developed a statistical model and it was validated using data from a prospective cohort. Among 1026 patients in the retrospective nationwide reperfusion therapy registry, 845 (82.3%) had at least one comorbidity. As the number of comorbidities increased, the likelihood of mortality within 6 months also increased (p < 0.001). Six out of the 19 comorbidities were included for developing the reperfusion comorbidity index on the basis of the odds ratios in the multivariate logistic regression analysis. This index showed good prediction of 6-month mortality in the retrospective cohort (area under the curve [AUC], 0.747; 95% CI, 0.704–0.790) and in 333 patients in the prospective cohort (AUC, 0.784; 95% CI, 0.709–0.859). Consideration of comorbidities might be helpful for the prediction of the 6-month mortality in patients with acute ischemic stroke who receive reperfusion therapy.