Ward reported a modification of the Charlson comorbidity index that is more specific for patients with systemic lupus erythematosus (SLE). This can help identify hospitalized patients with SLE who are at risk for in-hospital mortality. The author is from the VA Palo Alto Health Care System and Stanford University.
Number of conditions: 14
Range of points for each condition: 2 to 8 points (6 at 2 points, 4 at 3 points, 2 at 4 points, 1 at 6 points, 1 at 8 points)
|
Conditions |
Points |
|
cerebrovascular accident |
2 |
|
chronic renal failure |
2 |
|
congestive heart failure |
2 |
|
diabetes mellitus |
2 |
|
lupus nephritis |
2 |
|
pleuritis |
2 |
|
AIDS |
3 |
|
metastatic disease |
3 |
|
myocardial infarction |
3 |
|
pericarditis |
3 |
|
any malignancy |
4 |
|
thrombocytopenia |
4 |
|
peripheral vascular disease |
6 |
|
severe liver disease |
8 |
where:
• A malignant tumor with metastases would be scored 7 points.
• I would think there may be some exceptions to "any malignancy". I doubt if a superficial basal cell or squamous cell carcinoma of skin would be included.
total comorbidity index =
= SUM(points for all 14 items)
Interpretation:
• minimum index: 0
• maximum index: 46
• The higher the index the higher the rate of in-hospital mortality.
|
Index |
Hospital Mortality |
|
0 or 1 |
0 - 1.6% |
|
2, 3 or 4 |
5% |
|
5 or 6 |
7 - 9% |
|
7. 8 or 9 |
19 - 25% |
|
>= 10 |
37% |
from Figure 2, page 1411
Performance:
• The area under the ROC curve is 0.79.
Purpose: To evaluate comorbid conditions in a patient with systemic lupus erythematosus (SLE) using the SLE comorbidity index of Ward.
Objective: comorbid conditions
ICD-10: M32,
