Increased Charlson comorbidity index leads to worse postoper
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Charlson comorbidity index (CCI) score was associated with postoperative complications, mortality, and re-admission. The purpose of this study was to investigate the influence of comorbidities as calculated with CCI on postoperative clinical outcomes after PLIF.

Analysis included 366 patients who underwent an elective primary single-level PLIF. Postoperative clinical outcome was evaluated with the Japanese Orthopaedic Association lumbar score (JOA score). The correlation coefficient between the CCI score and postoperative improvement in JOA score was investigated. Patients were divided into three groups according to their CCI score (0, 1, and 2+). JOA improvement rate, length of stay (LOS), and direct cost were compared between each group. Postoperative complications were also investigated.

--There was a weak negative relationship between CCI score and JOA improvement rate (r = - 0.20).

--LOS and direct cost had almost no correlation with CCI score. The JOA improvement rate of group 0 and group 1 was significantly higher than group 2+.

--LOS and direct cost were also significantly different between group 0 and group 2+. There were 14 postoperative complications.

--Adverse postoperative complications were equivalently distributed in each group, and not associated with the number of comorbidities.

To conclude, a higher CCI score is correlated with a worse postoperative outcome. Patients with two or more comorbidities had a substantially higher recovery rate than patients without comorbidities. The CCI ranking, on the other hand, had no effect on LOS and increased direct costs. In order to produce a successful clinical result, the surgeon must consider the patient's comorbidities when preparing a surgical intervention.