 |
|
Validation of the Washington University Head and Neck Comorbidity Index in a Cohort of Older Patients
Alvaro Sanabria, MD, MSc, PhD;
André Lopes Carvalho, MD, PhD;
José Guilherme Vartanian, MD, PhD;
José Magrin, MD, PhD;
Mauro Kasuo Ikeda, MD, PhD;
Luiz Paulo Kowalski, MD, PhD
Arch Otolaryngol Head Neck Surg. 2008;134(6):603-607.
Objectives To validate the prognostic ability of the Washington University Head and Neck Comorbidity Index (WUHNCI) relative to 5-year survival in a cohort of older patients with head and neck cancer and to compare it with that of the Adult Comorbidity Evaluation 27 (ACE-27).
Design Validation study.
Setting Academic research.
Patients Three hundred twenty-one patients older than 70 years with head and neck cancer in a tertiary cancer center. Comorbidity was measured using the ACE-27, WUHNCI, and National Cancer Institute (NCI) comorbidity index.
Main Outcome Measure Five-year overall survival.
Results Five-year overall and cancer-specific survival, respectively, were as follows: Using the WUHNCI, 52.2% and 62.9% for a score of 0; 25.1% and 41.7% for a score of 1; 39.3% and 64.9% for a score of 2; and 19.5% and 45.0% for a score of 3 or higher. Using the ACE-27, 54.4% and 61.7% for a score of 0 (no comorbidity); 46.8% and 61.7% for a score of 1 (mild comorbidity); 31.7% and 51.6% for a score of 2 (moderate comorbidity); and 13.8% and 43.7% for a score of 3 (severe comorbidity). The C statistics were 0.641 for the NCI comorbidity index, 0.656 for the ACE-27, and 0.686 for the WUHNCI.
Conclusions The WUHNCI did not demonstrate good discriminative power compared with the ACE-27 in a cohort of older patients. To be widely used, instruments developed to measure comorbidities must be reliable in any population. We believe that the ACE-27 is still the best index to assess comorbidities and that it should be used in studies evaluating the prognostic effect of comorbidities.
Author Affiliations: Department of Surgery, School of Medicine, Universidad de La Sabana, Fundación Abood Shaio, Bogotá, Colombia (Dr Sanabria); and Department of Head and Neck Surgery and Otorhinolaryngology, Hospital do Câncer A. C. Camargo, Fundação Antonio Prudente, São Paulo, Brazil (Drs Carvalho, Vartanian, Magrin, Ikeda, and Kowalski).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Predictive Capacity of Three Comorbidity Indices in Estimating Mortality After Surgery for Colon Cancer
Hines et al.
JCO 2009;27:4339-4345.
ABSTRACT
| FULL TEXT
|
