Li et al reported comorbidity indices for patients undergoing repair of abdominal aortic aneurysms (AAA). One model is for endovascular repair, and another is for an open procedure. The authors are from George Washington University in Washington D.C.
Patient selection: abdominal aortic aneurysm, open surgical repair
Parameters:
(1) acquired immune deficiency syndrome
(2) alcohol abuse
(3) autoimmune condition
(4) lymphoma
(5) leukemia
(6) malignant solid tumor
(7) cerebrovascular accident
(8) dementia
(9) diabetes
(10) drug abuse
(11) hypertension
(12) liver disease
(13) chronic pulmonary disease
(14) obesity
(15) paralysis
(16) peripheral vascular disease
(17) renal failure
(18) hypothyroidism
(19) other thyroid disorders
(20) valvular disease
|
Parameter |
Finding |
Points |
|
acquired immune deficiency |
no |
0 |
|
|
yes |
-12 |
|
alcohol abuse |
no |
0 |
|
|
yes |
4 |
|
autoimmune condition |
no |
0 |
|
|
yes |
2 |
|
lymphoma |
no |
0 |
|
|
yes |
0 |
|
leukemia |
no |
0 |
|
|
yes |
-18 |
|
malignant solid tumor |
no |
0 |
|
|
in situ |
-30 |
|
|
without metastasis |
0 |
|
|
with metastasis |
16 |
|
cerebrovascular disease |
no |
0 |
|
|
yes |
30 |
|
dementia |
no |
0 |
|
|
yes |
16 |
|
depression |
no |
0 |
|
|
yes |
-16 |
|
diabetes |
no |
0 |
|
|
without chronic complication |
-2 |
|
|
with chronic complication |
-3 |
|
drug abuse |
no |
0 |
|
|
yes |
-7 |
|
hypertension |
no |
0 |
|
|
uncomplicated |
-28 |
|
|
complicated |
-14 |
|
liver disease |
no |
0 |
|
|
mild |
0 |
|
|
moderate or severe |
0 |
|
chronic pulmonary disease |
no |
0 |
|
|
yes |
-4 |
|
obesity |
no |
0 |
|
|
yes |
1 |
|
paralysis |
no |
0 |
|
|
yes |
-40 |
|
peripheral vascular disease |
no |
0 |
|
|
yes |
2 |
|
renal failure |
no |
0 |
|
|
mild or moderate |
0 |
|
|
severe |
21 |
|
hypothyroidism |
no |
0 |
|
|
yes |
-3 |
|
other thyroid disease |
no |
0 |
|
|
yes |
-16 |
|
valvular disease |
no |
0 |
|
|
yes |
-20 |
total OSR comorbidity index =
= SUM(points for all of the parameters)
Interpretation:
• minimum index: -197
• maximum index: 92
value of X =
= (0.035 * (OSR comorbidity index)) - 1.47
in-hospital mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.60.
