vacs_cci_score: Veterans Aging Cohort Study - Charlson Comorbidity Index (VACS-CCI)

Description

Calculates the VACS-CCI score, which adapts the Charlson Comorbidity Index for use in HIV-positive populations (and general populations) within the Veterans Aging Cohort Study context. It predicts all-cause mortality by summing weights for age and 17 specific comorbid conditions.

Usage

vacs_cci_score(age, sex, metastatic_cancer, aids, mild_liver_disease,
               moderate_severe_liver_disease, chronic_pulmonary_disease,
               dementia, hemiplegia, severe_kidney_disease, mild_kidney_disease,
               history_mi, congestive_heart_failure, peripheral_vascular_disease,
               cerebrovascular_disease, peptic_ulcer_disease,
               diabetes_uncomplicated, diabetes_complicated, rheumatic_disease,
               non_metastatic_cancer)

Value

A list containing:

VACS_CCI_Score: The calculated total score.
Interpretation: Context regarding mortality risk prediction.

Arguments

age: Numeric. Patient age in years. <50: 0 pts. 50-59: +1 pt. 60-69: +2 pts. 70-79: +3 pts. >=80: +4 pts.
sex: String. Patient sex ("male" or "female"). (Not weighted in score but part of demographic input).
metastatic_cancer: Numeric (0 or 1). Metastatic solid tumor. (1 = Yes, +6 pts).
aids: Numeric (0 or 1). AIDS diagnosis (not just HIV+). (1 = Yes, +6 pts).
mild_liver_disease: Numeric (0 or 1). Mild liver disease (e.g., chronic hepatitis, cirrhosis without portal hypertension). (1 = Yes, +2 pts). (Do not count if Moderate/Severe selected).
moderate_severe_liver_disease: Numeric (0 or 1). Moderate to severe liver disease (e.g., cirrhosis with portal hypertension, varices). (1 = Yes, +3 pts).
chronic_pulmonary_disease: Numeric (0 or 1). Chronic pulmonary disease (COPD). (1 = Yes, +1 pt).
dementia: Numeric (0 or 1). Dementia. (1 = Yes, +1 pt).
hemiplegia: Numeric (0 or 1). Hemiplegia or paraplegia. (1 = Yes, +2 pts).
severe_kidney_disease: Numeric (0 or 1). Moderate to severe kidney disease. (1 = Yes, +2 pts).
mild_kidney_disease: Numeric (0 or 1). Mild kidney disease. (1 = Yes, +1 pt). (Do not count if Severe selected).
history_mi: Numeric (0 or 1). Myocardial infarction. (1 = Yes, +1 pt).
congestive_heart_failure: Numeric (0 or 1). Congestive heart failure. (1 = Yes, +1 pt).
peripheral_vascular_disease: Numeric (0 or 1). Peripheral vascular disease. (1 = Yes, +1 pt).
cerebrovascular_disease: Numeric (0 or 1). Cerebrovascular disease. (1 = Yes, +1 pt).
peptic_ulcer_disease: Numeric (0 or 1). Peptic ulcer disease. (1 = Yes, +1 pt).
diabetes_uncomplicated: Numeric (0 or 1). Diabetes without chronic complications. (1 = Yes, +1 pt).
diabetes_complicated: Numeric (0 or 1). Diabetes with chronic complications. (1 = Yes, +2 pts). (Do not count Uncomplicated if Complicated selected).
rheumatic_disease: Numeric (0 or 1). Connective tissue/Rheumatic disease. (1 = Yes, +1 pt).
non_metastatic_cancer: Numeric (0 or 1). Any malignancy (including lymphoma/leukemia), except metastatic solid tumor or non-melanoma skin cancer. (1 = Yes, +2 pts).

References

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383. doi:10.1016/0021-9681(87)90171-8 Justice AC, et al. (Veterans Aging Cohort Study).

Examples

Run this code


# Example 1: High Risk
# 65yo (+2), Metastatic Cancer (+6), COPD (+1)
# Score = 9
vacs_cci_score(65, "male", 1, 0, 0, 0, 1, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0)

# Example 2: Low Risk
# 45yo (0), Uncomplicated Diabetes (+1)
# Score = 1
vacs_cci_score(45, "female", 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 1, 0, 0, 0)

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