Abstract
The objective of the present review is to mention the terminology used in home and foreign literature that concerns the complex of diseases, as well
as to study methods based on assessment of presence and severity of the comorbidity for treatment outcome prognosis and natural development of
diseases at the in-hospital stage of cardiac surgery aid.
At present in literature there is no common available terminology for description the presence of complex of syndromes and illnesses in a patient.
The most prevalent term in foreign literature is «comorbidity» used to describe impact of several illnesses on the outcome of the main illness in a
patient or group of patients and in home literature the term of «polypathia» i.e. combined pathology.
Now 13 methods have been worked out for scoring measurement of comorbidity. Six indexes have been based on carefully elaborated list of certain
diagnoses (BOD, Charlson Index, Hallstrom Index, Incalzi Index, Liu Index, Shwartz Index). Three indexes reflect the «ranged» influence of
comorbidity conditions on concrete organs and systems (CIRS, ICED, Kaplan Index). Two indexes allow assessing comorbidity conditions on the
basis of 3–4 scales with different categories (Cornoni–Huntley Index и Hurwitz Index). Two methods presume calculation of amount of combined
pathologies (Disease count, DUSOI). There are also scales GIC (Geriatric Index of Comorbidity, 2002), FCI (Func tional Comorbidity Index,
2005), TIBI (Total Illness Burden Index, 2009) as well as the number of scales allowing patients assessing their own comorbidity.
EuroSCORE is prevailed in cardiac surgery but some researches have come to the conclusion that the risk evaluation on the basis of this model
can be used neither for enrolling of patients for cardiac surgery nor comparison of outcomes between hospitals. Working group of European Society
for Cardiovascular Surgery has considered that risk scales EuroSCORE, STS, AmblerSCORE is effective while assessing probability of lethal outcome
in group of patients but has not suited to predict the individual risk of lethal outcome.
While conducting researches aimed at assessment of influence of several diseases or conditions on prognosis and quality of life of patients in
English language literature the Charlson Index, CIRS, ICED, Kaplan Index are more frequently used. In cardiac surgery in order to work out
the short-term prognosis the scales based on certain factors proved prognostic importance in large selection of patients have been used. At the same
time the importance of methods mentioned in the present review regarding assessment of comorbidity for prognosis and tactics of management
of patients hospitalized for cardiac surgery still has to be studied.
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3 ст Обзоры
About the authors
Samorodskaya Irina Vladimirovna, Doctor of Medical Sciences, professor, chief surgeon of V.I. Burakovskiy Institute for Coronary and Vascular Surgery of A.N. Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences;
Nikiforova Mariya Aleksandrovna, physician-cardiologist
