Modified Charlson Comorbidity Index of Volk et al for a Patient After Liver Transplantation

Description

Volk et al developed a simplified Charlson comorbidity score for evaluating a patient who has had a liver transplant. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Michigan and University of California Los Angeles.

Patient selection: status post liver transplantation

Outcome: mortality

Parameters:

(1) coronary artery disease (ischemic heart disease)

(2) diabetes mellitus

(3) COPD

(4) connective tissue disease (autoimmune rheumatologic disorder SLE, RA, scleroderma, etc)

(5) renal insufficiency (serum creatinine >= 1.5 mg/dL, renal transplant)

Parameter	Finding	Points
coronary artery disease	absent	0
	present	2
diabetes mellitus	absent	0
	present	1
COPD	absent	0
	present	3
rheumatologic disorder	absent	0
	present	2
renal insufficiency	absent	0
	present	2

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 10

• Almost all patients in the study had a score from 0 (62%) to 3 (6%).

Score	Hazard Ratio for Mortality
0	1
1	1.6
2 to 5	2.2

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