ArticleBMC geriatrics2024
External Validation of the Charlson Comorbidity Index-based Model for Survival Prediction in Thai Patients Diagnosed with Dementia.
Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Unsupervised characterization of 100,272 EHR patients identifies high-risk groups and comorbidities linked to premature aging.NPJ digital medicine · 2026Article
- Evaluating cross-country applicability of morbidity scores: validation of the Multisource Comorbidity Score in Catalonia.European journal of public health · 2026Observational
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Authors and funding
7 authors.
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Abstract
backgroundThe Charlson Comorbidity Index (CCI) is commonly employed for predicting mortality. Nonetheless, its performance has rarely been evaluated in patients with dementia. This study aimed to examine the predictive capability of the CCI-based model for survival prediction in Thai patients diagnosed with dementia.
methodsAn external validation study was conducted using retrospective data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai Hospital between 2006 and 2012. The data obtained from electronic medical records included age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis. The discriminative ability and calibration of the CCI-based model were estimated using Harrell's C Discrimination Index and visualized with calibration plot. As the initial performance did not meet satisfaction, model updating and recalibration were performed.
resultsOf 702 patients, 56.9% were female. The mean age at dementia diagnosis was 75.22 (SD 9.75) year-old. During external validation, Harrell's C-statistic of the CCI-based model was 0.58 (95% CI, 0.54-0.61). The model showed poor external calibration. Model updating was subsequently performed. All updated models demonstrated a modest increase in Harrell's C-statistic. Temporal recalibration did not significantly improve the calibration of any of the updated models.
conclusionThe CCI-based model exhibited fair discriminative ability and poor calibration for predicting survival in Thai patients diagnosed with dementia. Despite attempts at model updating, significant improvements were not achieved. Therefore, it is important to consider the incorporation of other influential prognostic factors.
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