Modified ACE-27 comorbidity rating scheme used in SHIELD study
| Comorbidity scale . | Grade 1 . | Grade 2 . | Grade 3 . | Grade 4 . | Grade 5 . |
|---|---|---|---|---|---|
| Instructions: | |||||
| 1. Select a grade for each of the systems. | |||||
| 2. Press the calculate button to add up the number of individual grades. | |||||
| 3. Use the totals to work out which answer to use (frail/not frail). | |||||
| All grade 1 (not frail) | |||||
| All grade 2 or less (not frail) | |||||
| Two grade 3 or higher (not frail) | |||||
| More than three grade 3 or at least one grade 4/5 (“frail”) | |||||
| Grade key | |||||
| 1. No disability | |||||
| 2. Low disability (it does not interfere with normal activities; treatment is optional; very good prognosis) | |||||
| 3. Mild disability (it interferes with normal activities; treatment is needed; good prognosis) | |||||
| 4. Severe disability (disabling, urgent treatment is needed; poor prognosis) | |||||
| 5. Very severe disability (it can be fatal; emergency treatment is needed; danger list) | |||||
| System | |||||
| Heart (heart only) | ○ | ○ | ○ | ○ | ○ |
| Hypertension (hypertension severity is considered) | ○ | ○ | ○ | ○ | ○ |
| Vascular (both venous and artery districts) | ○ | ○ | ○ | ○ | ○ |
| Diabetes | ○ | ○ | ○ | ○ | ○ |
| Respiratory | ○ | ○ | ○ | ○ | ○ |
| Gastrointestinal | ○ | ○ | ○ | ○ | ○ |
| Liver | ○ | ○ | ○ | ○ | ○ |
| Kidney | ○ | ○ | ○ | ○ | ○ |
| Other genitourinary | ○ | ○ | ○ | ○ | ○ |
| Bone and muscle | ○ | ○ | ○ | ○ | ○ |
| Nervous system (central and peripheral, dementia is excluded) | ○ | ○ | ○ | ○ | ○ |
| Eyes and ENT (eyes, ears, nose, larynx) | ○ | ○ | ○ | ○ | ○ |
| Endocrine system and metabolism (diabetes excluded) | ○ | ○ | ○ | ○ | ○ |
| Calculate: | |||||
| If “frail,” not eligible for VEPEMB study | 1's | 2's | 3's | 4's | 5's |
| Total | ○ | ○ | ○ | ○ | ○ |
| Comorbidity scale . | Grade 1 . | Grade 2 . | Grade 3 . | Grade 4 . | Grade 5 . |
|---|---|---|---|---|---|
| Instructions: | |||||
| 1. Select a grade for each of the systems. | |||||
| 2. Press the calculate button to add up the number of individual grades. | |||||
| 3. Use the totals to work out which answer to use (frail/not frail). | |||||
| All grade 1 (not frail) | |||||
| All grade 2 or less (not frail) | |||||
| Two grade 3 or higher (not frail) | |||||
| More than three grade 3 or at least one grade 4/5 (“frail”) | |||||
| Grade key | |||||
| 1. No disability | |||||
| 2. Low disability (it does not interfere with normal activities; treatment is optional; very good prognosis) | |||||
| 3. Mild disability (it interferes with normal activities; treatment is needed; good prognosis) | |||||
| 4. Severe disability (disabling, urgent treatment is needed; poor prognosis) | |||||
| 5. Very severe disability (it can be fatal; emergency treatment is needed; danger list) | |||||
| System | |||||
| Heart (heart only) | ○ | ○ | ○ | ○ | ○ |
| Hypertension (hypertension severity is considered) | ○ | ○ | ○ | ○ | ○ |
| Vascular (both venous and artery districts) | ○ | ○ | ○ | ○ | ○ |
| Diabetes | ○ | ○ | ○ | ○ | ○ |
| Respiratory | ○ | ○ | ○ | ○ | ○ |
| Gastrointestinal | ○ | ○ | ○ | ○ | ○ |
| Liver | ○ | ○ | ○ | ○ | ○ |
| Kidney | ○ | ○ | ○ | ○ | ○ |
| Other genitourinary | ○ | ○ | ○ | ○ | ○ |
| Bone and muscle | ○ | ○ | ○ | ○ | ○ |
| Nervous system (central and peripheral, dementia is excluded) | ○ | ○ | ○ | ○ | ○ |
| Eyes and ENT (eyes, ears, nose, larynx) | ○ | ○ | ○ | ○ | ○ |
| Endocrine system and metabolism (diabetes excluded) | ○ | ○ | ○ | ○ | ○ |
| Calculate: | |||||
| If “frail,” not eligible for VEPEMB study | 1's | 2's | 3's | 4's | 5's |
| Total | ○ | ○ | ○ | ○ | ○ |