Schneeweis et al adjusted weights assigned to various comorbid conditions in the Chronic Disease Score based on risk seen in patients from New Jersey. The authors are from Brigham and Women's Hospital.
Patient selection: Medicare (primarily >= 65 years)
Therapy
Original CDS1
Adjusted Weight
1 class of heart disease agents
3
1
2 classes of heart disease agents
4
3
3 classes of heart disease agetns
5
4
one class of respiratory agents
2
1
2 classes of respiratory agents
3
2
glucocorticoids
3
1
gold salts
3
-1
antineoplastics
3
3
L-dopa
3
2
antihypertensive not ACEI; calcium channel blockers
2
0
beta blocker or diuretic
1
0
anti-diabetic (insulin, oral)
2
1
anticonvulsant
2
2
cromolyn
2
-2
anti-acne (tretinoin; topical macrolides)
1
-2
cimetidine
1
1
ophthalmic miotics
1
0
uric acid agents
1
0
antilipidemics
1
-2
ergot derivatives
1
-1
antitubercular agents
1
2
where:
• Heart disease classes: anti-coagulants or hemostatics; cardiac agents or ACE inhibitors; loop diuretics
• Respiratory agents: isoproterenol; beta-adrenergic; xanthines; bronchodilators and non-cromyln mucolytics; epinephrine
• Some of the agents in the table appear dated, while newer agents are missing.
total comorbidity =
= SUM(points assigned to all conditions)
Interpretation:
• minimum score: -9
• maximum score: 18
• The higher the total score the greater the risk for the patient.
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