Corrao et al reported the Multisource Comorbidity Score (MCS) as a measure of comorbidity. This can aid in risk adjustment. The authors are from multiple institutions in Italy.
|
Parameter |
Points |
|
cancer, metastatic |
18 |
|
alcohol abuse |
11 |
|
cancer, nonmetastatic |
10 |
|
tuberculosis |
10 |
|
psychosis |
8 |
|
liver disease |
8 |
|
anxiety medication |
6 |
|
weight loss |
6 |
|
dementia |
6 |
|
malignancy medication |
5 |
|
Parkinson's disease |
5 |
|
malignant lymphoma |
5 |
|
hemiplegia or hemiparesis |
5 |
|
coagulation defects |
5 |
|
disorder of fluid, electrolytes or acid-base balance |
4 |
|
kidney disease |
4 |
|
kidney dialysis |
4 |
|
heart failure |
4 |
|
other neurological diseases |
3 |
|
rheumatoid arthritis |
3 |
|
anemia |
3 |
|
cerebrovascular disease |
3 |
|
diabetes |
2 |
|
vascular diseases |
2 |
|
gout |
2 |
|
epilepsy |
2 |
|
chronic pulmonary diseases |
2 |
|
peptic ulcer |
2 |
|
acute myocardial infarction |
1 |
|
coronary and peripheral vascular disease |
1 |
|
valvular disease |
1 |
|
cardiac arrhythmias |
1 |
|
obesity |
1 |
|
hypothyroidism |
1 |
where:
• It is assumed that each is independent except for cancer. Therefore, a person who receiving chemotherapy for metatastatic cancer would receive 23 points and a patient with end-stage renal disease on dialysis would get 8 points.
• Malignant lymphoma is separate from cancer.
• The list of conditions is limited.
• The distinction between vascular disease and coronary and peripheral vascular disease is uncertain.
total aggregate score =
= SUM(points for all conditions present)
The total aggregate score was then mapped into a category designated the Multisource Comorbidity Score (MCS).
|
Aggregate Score |
Category (MCS) |
5-Year Mortality |
|
0 to 4 |
0 |
7% |
|
5 to 9 |
1 |
26% |
|
10 to 14 |
2 |
31% |
|
15 to 19 |
3 |
48% |
|
>= 20 |
4 |
62% |
Performance:
• The area under the ROC curve is 0.78.
