The Charlson Comorbidity Index for Heart Failure with Reduced Ejection Fraction Prognosis Prediction
Zeineb Hamdani *
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Hajar Hatim
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Mehdi Rochd
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Taha Ettachfini
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Bouziane Maha
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Haboub Meryem
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Selim Arous
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Abdenasser Drighil
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
Rachida Habbal
Department of Cardiology, Ibn Rochd Hospital, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Aims: To assess the prognostic value of the Charlson comorbidity index (CCI) for predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HRrEF) in a north African context.
Study Design: Prospective, single-center observational study.
Place and Duration of Study: Conducted at the therapeutic heart failure unit, Ibn Rochd hospital, Casablanca, Morocco, from march to October 2022.
Methodology: We enrolled 188 adult patients diagnosed with HFrEF (left ventricular ejection fraction <40%). Comorbidities were recorded at admission and scored using the CCI. Patients were divided into two groups based on a cci cutoff of 5. The primary outcome was all-cause mortality tracked during follow-up. Survival differences were analyzed using Kaplan-Meier curves and statistical comparison tests.
Results: The average age was 63 ± 12 years, with a male-to-female ratio of 2:1. The mean cci score was 3.65 ± 1.45. Hypertension, diabetes, and chronic obstructive pulmonary disease were the most frequent comorbidities. During follow-up, 44 patients (23.4%) died. Mortality was significantly higher in patients with a cci score above 5 (P < 0.001). Mean survival was 6.02 months for the low cci group and 4.38 months for the high cci group.
Conclusion: The Charlson comorbidity index is a simple and effective tool to predict mortality risk in HFrEF patients. Its use can improve risk stratification and support tailored management, especially in settings with limited resources.
Keywords: Heart failure, comorbidity, charlson comorbidity index, mortality, risk assessment, prognostic models, observational studies