Jiang et al reported a Multiple Chronic Conditions (MCC) Index for a patient who has had an ischemic stroke. This can help to identify a patient who is more likely to have a worse functional outcome. The authors are from the University of Michigan and VA Geriatric Research Education and Clinical Center in Ann Arbor.
Patient selection: ischemic stroke
Outcome: functional dependence
Parameters:
(1) prestrokemodified Rankin scale (mRS)
(2) history of prior stroke or TIA
(3) age in years
(4) dementia
(5) congestive heart failure with or without heart failure
(6) weight loss (Kwashiorkor, marasmus, or protein-calorie malnutrition)
(7) diabetes
(8) other neurologic disorder
PrestrokemRS
Prior stroke or TIA
Points
0
no
0
yes
0
1
no
2
yes
3
2
no
4
yes
6
3
no
6
yes
9
4
no
8
yes
12
5
no
10
yes
15
Age in Years
Dementia
Points
45 to 54
no
0
yes
0
55 to 64
no
1
yes
2
65 to 74
no
2
yes
4
75 to 84
no
3
yes
6
85 to 94
no
4
yes
8
95 to 105
no
5
yes
10
Parameter
Finding
Points
CHF
without renal failure
2
with renal failure
4
absent
0
weight loss
no
0
yes
4
diabetes
no
0
yes
1
other neurologic disorder
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpertation:
• minimum score: 0
• maximum score: 35
• The risk of functional dependence increases with the MCC index.
• An index > 12 has a significant risk for functional dependence.
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