Lakomkin et al used a modified Charlson Comorbidity Index (CCI) to evaluate a patient prior to spine tumor surgery. The modified CCI was predictive of mortality, complications and length of stay. The authors are from Vanderbilt University, Yale School of Medicine, Stanford University, University of Utah, University of Cincinnati and Zucker School of Medicine at Hofstra/Northwell.
Parameters:
(1) age in years
(2) peripheral vascular disease or pain at rest (lower extremity)
(3) congestive heart failure (CHF)
(4) prior myocardial infarction (MI)
(5) diabetes mellitus
(6) prior transient ischemic attack (TIA) or stroke
(7) COPD
(8) renal failure
(9) hemiplegia
(10) ascites or esophageal varices (markers of cirrhosis)
(11) disseminated cancer
Parameter
Finding
Points
age in years
<= 40
0
41 to 50
1
51 to 60
2
61 to 70
3
> 70
4
peripheral vascular disease
no
0
yes
1
CHF
no
0
yes
1
myocardial infarction
no
0
yes
1
diabetes mellitus
no
0
yes
1
prior TIA or stroke
no
0
yes
1
COPD
no
0
yes
1
renal failure
no
0
yes
2
hemiplegia
no
0
yes
2
ascites or varices
no
0
yes
3
disseminated cancer
no
0
yes
6
total score =
= SUM(points for all 11 years)
Interpretation:
• minimum score: 0
• maximum score: 23
• The higher the score the greater the risk of an adverse outcome following surgery.
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