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End-Stage Renal Disease (ESRD) | Modified Charlson Comorbidity Index

Purpose: To evaluate a patient with end-stage renal disease (ESRD) for comorbidity using the modified Charlson Comorbidity Index of Hemmelgarn et al.

Description

Hemmelgarn et al adapted the Charlson Comorbidity Index (CCI) for patients in end-stage renal disease (ESRD). The authors are from the University of Calgary and the Institute of Health Economics in Edmonton.


 

Patient selection: end-stage renal disease

 

Number of conditions scored: 13 (4 less than CCI, diabetes and liver disease counted once)

Condition

Weight in Charlson Index

Weight in Current Index

myocardial infarction

1

2

congestive heart failure

1

2

peripheral vascular disease

1

1

cerebrovascular disease

1

2

dementia

1

1

chronic pulmonary disease

1

1

connective tissue disease (rheumatological)

1

1

peptic ulcer disease

1

1

liver disease, mild

1

NA

diabetes without complications

1

2

hemiplegia

2

NA

renal disease, moderate or severe

2

NA (inclusion)

diabetes with end organ damage

2

1

any malignancy

2

NA

leukemia

2

2

malignant lymphoma

2

5

liver disease, moderate or severe

3

2

metastatic solid malignancy

6

10

AIDS

6

NA

 

where:

• Some conditions were not present in a sufficient number of patients to evaluate.

• It is unclear if leukemia and lymphoma are independent or not.

 

total score =

= SUM(points for all conditions)

 

Interpretation:

• minimum score: 0 (no coorbidities)

• maximum score: 32

• The higher the score the worse the overall survival.

 

Total Score

2-Year Survival

1

93%

2 or 3

78%

4

88%

5

52%

6

35%

 


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Objective

ICD-10