The Efficacy of the Charlson Comorbidity Index and Its Age-Adjusted Version in Forecasting Mortality and Postoperative Outcomes Following Isolated Coronary Artery Bypass Grafting

<b>Background/Objectives</b>: The Charlson Comorbidity Index (CCI) is designed for evaluating comorbidities and mortality risks, with the age-adjusted CCI (ACCI) combining age and comorbidity assessments. Despite its long-standing use, research on CCI's application in cardiac surgery patients is limited. This study assessed the effectiveness of CCI and ACCI in predicting in-hospital mortality and post-surgery outcomes for patients undergoing isolated coronary artery bypass grafting (CABG). <b>Methods</b>: CCI and ACCI scores were derived from medical records between 2016 and 2022. Patient demographics, surgical techniques, and postoperative complications were documented. <b>Results</b>: Totally 393 patients [297 (75.6%) males, 96 (24.4%) females] with an average age of 65 years were included. Median CCI and ACCI scores were 1 (1-2) and 4 (3-5), respectively. In-hospital mortality occurred in 5.9% (n = 23) of cases, with CCI being an independent predictor (OR 1.865, 95% CI 1.117-3.116; <i>p</i> = 0.017). Both CCI and ACCI scores negatively correlated with preoperative EF (%) and positively correlated with ICU and total hospital stay, cardiopulmonary bypass time, and cross-clamp time. ACCI score also positively correlated with extubation time. Patients categorized by CCI comorbidity severity (no comorbidity, mild, moderate, severe) showed a significant increase in postoperative complications with increasing severity, including postoperative VT (<i>p</i> = 0.000), acute renal failure (<i>p</i> = 0.009), pneumonia (<i>p</i> = 0.007), and in-hospital mortality (<i>p</i> = 0.001). <b>Conclusions</b>: Both CCI and ACCI are prognostic indicators for in-hospital mortality in isolated CABG surgery patients, effectively predicting postoperative complications, extended ICU stays, and prolonged hospital stays. Implementing these scoring systems could enhance patient care and improve surgical decision-making.