Description

Incalzi et al reported an index combining age and comorbid conditions. The authors are from the Universita Cattolica del Sacro Cuore in Rome and Cittadella della Carita in Taranto, Italy.


Parameters: see table

 

Parameter

Finding

Points

age in years

< 76 years

0

 

76 to 85 years

2

 

86 to 95 years

3

 

> 95 years

4

chronic lymphocytic leukemia

absent

0

 

Stage A or B

2

 

Stage C

6

multiple myeloma

absent

0

 

stage I

2

 

stage II

4

 

stage III

6

Hodgkin's disease

absent

0

 

Stage I or II

2

 

Stage III

6

congestive heart failure (CHF)

absent

0

 

NYHA I or II

1

 

NYHA III or IV

4

renal failure

absent

0

 

mild to moderate

1

 

severe

4

decubitus ulcer

absent

0

 

Stage 1 or 2

1

 

Stage 3

4

chronic myelogenous leukemia

absent

0

 

early stage

2

 

blast crisis

6

chronic lung disease

absent

0

 

COPD

1

 

chronic failure, Stage I

2

 

chronic failure, Stage II or III

4

cancer

absent

0

 

localized disease

2

 

metastatic

4

 

peritoneal carcinomatosis

6

diabetes mellitus

absent

0

 

without organ damage

1

 

with organ damage

2

dementia

absent

0

 

without anorexia, akinesia, dysphagia, decubiti

1

 

with complications

4

Parkinson's disease

absent

0

 

present without complications

1

 

with complications

4

liver disease

absent

0

 

mild, including steatosis

1

 

chronic active hepatitis

4

 

cirrhosis

4

pancreatitis

absent

0

 

chronic

1

 

acute

2

cerebrovascular disease

absent

0

 

TIA

1

 

ischemic stroke

2

 

parenchymous hemorrhages

6

collagen vascular disease

absent

0

 

early stage

1

 

with organ damage

4

anemia

absent

0

 

mild (hemoglobin < 10 g/dL)

1

 

aplastic anemia with transfusions at intervals > 20 days

2

 

aplastic anemia with transfusions at intervals <= 20 days

4

non-Hodgkin's lymphoma

absent

0

 

present

6

acute leukemia

absent

0

 

present

6

sepsis

absent

0

 

present

4

pulmonary thromboembolism

absent

0

 

past history of

1

 

present

4

infectious endocarditis

absent

0

 

present

4

meningitis or encephalitis

absent

0

 

present

4

multiple sclerosis

absent

0

 

present

2

myasthenic gravis

absent

0

 

early disease

2

hypertension

absent

0

 

present

1

peripheral arterial disease

absent

0

 

present

1

peptic ulcer disease

absent

0

 

present

1

idiopathic inflammatory bowel disease (Crohn's, UC)

absent

0

 

present

1

thyroid disease

absent

0

 

present (hyper or hypo)

1

 

where:

• Collagenosis was interpreted as meaning collagen vascular disease.

• A number of items could have additional entries (such as myasthenia).

 

comorbidity index without age =

= SUM(points for all items other than age)

 

comorbidity index with age =

= (index without age) + (points for age)

 

Interpretation:

• minimum score: 0

• maximum score: > 50

• The higher the score the more severe the comorbidity.

• An age-comorbidity index > 7 was associated with an increased risk of mortality.


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