Serum albumin and FT3/FT4 ratio as additional co-morbidity parameters to predict mortality as a new approach: The Haseki Scoring Index (updated Charlson Comorbidity Index)

Abstract

Background Charlson Comorbidity Index (CCI) is the common and valid method to predict mortality by classifying comorbidities such as cardiovascular, metabolic, renal, hepatic, pulmonary diseases, and malignancy. Novel risk factors are not included in the Charlson Comorbidity Index, such as thyroid hormone index (FT3/FT4 ratio) and serum albumin levels. In the present study, we aimed to assess whether the thyroid hormone index and albumin are useful clinical parameters in short and long-term mortality. Methods In the retrospective cohort study with a 5 year follow up, the data of 1292 patients who were hospitalized between January 1st–June 30th of 2014 were examined. Three months mortality as short term and 5-year mortality as long term were evaluated. Results Three months and 5 years mortality rates for 1064 patients were analyzed. We showed that hypoalbuminemia and thyroid hormone index had statistically significant effects on short and long-term mortality. According to ROC analysis it was demonstrated that the scoring system including biochemical parameters such as thyroid hormone index and serum albumin level was more significant for 3-month mortality. In addition, both scoring systems are equal in demonstrating long-term mortality. Conclusion Thyroid hormone index and albumin could improve the prognostic performance of the original Charlson Comorbidity Index in short term mortality. The combined score may offer improvements in comorbidity summarization over existing scores.