Modern approaches to the assessment of comorbidity in patients

Gulzhan I. Sarsenbaeva, Anar Tursynbekova

2019

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.26442/22217185.2019.1.180073
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Aim. To provide modern data on advantages and disadvantages of available international comorbidity scales and indices. Materials and methods. Data of 29 scientific sources published in Russian and foreign literature press within 1973-2018 are considered. Results. The presence of comorbidity in a patient is an issue of modern medicine. In most cases some comorbid diseases if timely diagnosed and managed in accordance with algorithms for medical care can be corrected and treated. In order to control risks of development of complications and to prescribe an effective therapy for comorbidity the international and national clinical guidelines have been created. They include algorithms for clinical and instrumental assessment of complications and provide scales and indices, such as Cumulative lllness Rating Scale (CIRS), Charlson comorbidity index, Kaplan-Feinstein index, Index of Co-Existent Disease (ICED), Geriatric Index of Comorbidity (GIC), Functional Comorbidity Index (FCI) et al. Data of Canadian comparative study of 5 international scales of comorbidity in patients with head and neck cancers showed a significant impact of comorbidity on survival of patients with different stages of neoplasms. It was emphasized that the index of comorbidity is necessary to control an impact of comorbid diseases on the patients' status in the long-term period. The Kaplan-Feinstein scale was the best index for assessing a survival of patients with head and neck cancer. According to V.de Groot, the most widely studied comorbidity index for predicting mortality is the Charlson index. Each index has its advantages and disadvantages and is used in different clinical situations. Conclusion. General comorbidity index is a comprehensive summary score of a disease combination or severity, which combines all conditions, problems and illnesses of patients, weights them by severity, and it significantly affects treatment tactics and outcome in a future.