Mehta et al reported the Summary Elixhauser score for evaluating the impact of comorbidities for a patient. There are 4 separate weightings, one of which is for in-hospital mortality based on AHRQ data. The authors are from the Johns Hopkins University and the University of Texas Medical Branch at Galveston.
Patient selection: older adult
Parameters:
(1) solid cancer
(2) leukemia
(3) lymphoma
(4) dementia
(5) congestive heart failure
(6) weight loss
(7) renal disease
(8) liver disease
(9) coagulopathy
(10) deficiency anemia
(11) paralysis
(12) peripheral vascular disease
(13) pulmonary circulatory disorder
(14) chronic pulmonary disease
(15) cerebrovascular disease
(16) thyroid disease
(17) peptic ulcer disease with bleeding
(18) valvular disease
(19) alcohol misuse
(20) blood loss anemia
(21) depression
(22) diabetes
(23) psychosis
(24) seizures and epilepsy
(25) arthroplastiies
(26) hypertension
(27) AIDS/HIV
(28) drug misuse
(29) obesity
|
Parameter |
Finding |
Points |
|
solid cancer |
none |
0 |
|
|
in situ |
10 |
|
|
without metastases |
10 |
|
|
metastatic |
23 |
|
renal disease |
none |
0 |
|
|
moderate |
3 |
|
|
severe |
8 |
|
liver disease |
none |
0 |
|
|
mild |
2 |
|
|
moderate or severe |
17 |
|
neurological disorders |
none |
0 |
|
|
affecting movement |
-1 |
|
|
other |
23 |
|
diabetes |
no |
0 |
|
|
uncomplicated |
0 |
|
|
complicated |
-2 |
|
hypertension |
none |
0 |
|
|
uncomplicated |
0 |
|
|
complicated |
1 |
|
thyroid disease |
none |
0 |
|
|
hypothyroidism |
-3 |
|
|
other |
-8 |
|
Parameter |
Points if Present |
|
dementia |
5 |
|
congestive heart failure |
15 |
|
weight loss |
14 |
|
leukemia |
9 |
|
coagulopathy |
15 |
|
deficiency anemia |
2 |
|
paralysis |
2 |
|
peripheral vascular disease |
2 |
|
pulmonary circulatory disease |
3 |
|
chronic pulmonary disease |
2 |
|
lymphoma |
2 |
|
cerebrovascular disease |
-1 |
|
peptic ulcer with bleeding |
-1 |
|
valvular disease |
0 |
|
alcohol misuse |
-1 |
|
blood loss anemia |
-4 |
|
depression |
-9 |
|
psychosis |
-9 |
|
seizures and epilepsy |
2 |
|
arthroplasties |
-1 |
|
AIDS/HIV |
-4 |
|
drug misuse |
-7 |
|
obesity |
-7 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -55
• maximum score: 145
