Burden of Illness Score for Elderly Persons (BISEP) of Inouye et al

Description

Inouye et al developed the Burden of Illness Score for Elderly Persons (BISEP). This can help to identify an older adult who may benefit from more aggressive management. The authors are from VA Connecticut Healthcare System West Haven and Yale University in New Haven, Connecticut.

Patient selection: >= 65 years of age

Parameters:

(1) high risk diagnosis group, based on a comorbidity score of 10 conditions (the High-Risk Diagnoses for the Elderly Scale of Desai et al)

(2) serum creatinine in mg/dL

(3) serum albumin in g/dL

(4) dementia (including chronic cognitive impairment, Alzheimer's disease, organic brain syndrome)

(5) walking impairment

Parameter	Finding	Points
high risk diagnosis	none (Group A)	0
	mild (Group B)	1
	moderate (Group C)	2
	severe (Group D)	3
serum creatinine	<= 1.5 mg/dL	0
	> 1.5 mg/dL	1
serum albumin	> 3.5 g/dL	0
	<= 3.5 g/dL	1
dementia	absent	0
	present	1
walking impairment	absent	0
	present	1

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the worse the outcome.

Total Score	1-Year Mortality (Development Cohort)
0	6%
1	10%
2	25%
3	50%
4	68%
5	88%
6 or 7	88%

Performance:

• The area under the ROC curve was 0.77.

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