Van Walraven et al reported a modification of the Elixhauser Comorbidity Index. This resulted in a point system that was predictive of hospital death. The authors are from Ottawa Health Research Institute in Canada.
Parameters:
(1) acquired immune deficiency syndrome
(2) alcohol abuse
(3) anemia
(4) rheumatoid arthritis or collagen vascular disease
(5) congestive heart failure
(6) chronic pulmonary disease
(7) coagulopathy
(8) depression
(9) diabetes
(10) drug use
(11) hypertension
(12) hypothyroidism
(13) liver disease
(14) lymphoma
(15) fluid and electrolyte disorder
(16) cancer
(17) other neurological disorders
(18) obesity
(19) paralysis
(20) peripheral vascular disorders
(21) psychosis
(22) pulmonary circulation disorders
(23) renal failure
(24) peptic ulcer disease excluding bleeding
(25) valvular disease
(26) weight loss
(27) cardiac arrhythmia
|
Parameter |
Finding |
Points |
|
acquired immune deficiency syndrome |
no |
0 |
|
|
yes |
0 |
|
alcohol abuse |
no |
0 |
|
|
yes |
0 |
|
anemia |
none |
0 |
|
|
deficiency |
-2 |
|
|
blood loss |
-2 |
|
|
other |
0 (? -2) |
|
rheumatoid arthritis, collagen vascular disease |
no |
0 |
|
|
yes |
0 |
|
congestive heart failure |
no |
0 |
|
|
yes |
7 |
|
chronic pulmonary disease |
no |
0 |
|
|
yes |
3 |
|
coagulopathy |
no |
0 |
|
|
yes |
3 |
|
depression |
no |
0 |
|
|
yes |
-3 |
|
diabetes |
no |
0 |
|
|
uncomplicated |
0 |
|
|
complicated |
0 |
|
drug abuse |
no |
0 |
|
|
yes |
-7 |
|
hypertension |
no |
0 |
|
|
yes |
0 |
|
hypothyroidism |
no |
0 |
|
|
yes |
0 |
|
liver disease |
no |
0 |
|
|
yes |
11 |
|
lymphoma |
no |
0 |
|
|
yes |
9 |
|
fluid and electrolyte disorder |
no |
0 |
|
|
yes |
5 |
|
other neurological disorders |
no |
0 |
|
|
yes |
6 |
|
obesity |
no |
0 |
|
|
yes |
-4 |
|
paralysis |
no |
0 |
|
|
yes |
7 |
|
peripheral vascular disorder |
no |
0 |
|
|
yes |
2 |
|
renal failure |
no |
0 |
|
|
yes |
5 |
|
cancer |
no |
0 |
|
|
without metastases |
4 |
|
|
with metastases |
12 |
|
psychosis |
no |
0 |
|
|
yes |
0 |
|
pulmonary circulation disorder |
no |
0 |
|
|
yes |
4 |
|
renal failure |
no |
0 |
|
|
yes |
5 |
|
peptic ulcer |
no |
0 |
|
|
yes |
0 |
|
valvular disease |
no |
0 |
|
|
yes |
-1 |
|
weight loss |
no |
0 |
|
|
yes |
6 |
|
cardiac arrhythmia |
no |
0 |
|
|
yes |
5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -17
• maximum score: 85
• The higher the score the greater the hospital mortality.
