title: Comorbidity polypharmacy score and its clinical utility: A pragmatic practitioner's perspective.
abstract: Modern medical management of comorbid conditions has resulted in escalating use of multiple medications and the emergence of the twin phenomena of multimorbidity and polypharmacy. Current understanding of how the polypharmacy in conjunction with multimorbidity influences trauma outcomes is limited, although it is known that trauma patients are at increased risk for medication-related adverse events. The comorbidity-polypharmacy score (CPS) is a simple clinical tool that quantifies the overall severity of comorbidities using the polypharmacy as a surrogate for the "intensity" of treatment necessary to adequately control chronic medical conditions. Easy to calculate, CPS is derived by counting all known pre-injury comorbid conditions and medications. CPS has been independently associated with mortality, increased risk for complications, lower functional outcomes, readmissions, and longer hospital stays. In addition, CPS may help identify older trauma patients at risk of post-emergency department undertriage. The goal of this article was to review and refine the rationale for CPS and to provide an evidence-based outline of its potential clinical applications.
authors.affiliation: Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA ; Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
authors.forename: Stanislaw P
authors.initials: SP
authors.lastname: Stawicki
authors.affiliation: Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA ; Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
authors.forename: Sarathi
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Jones
authors.affiliation: Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Carla F
authors.initials: CF
authors.lastname: Justiniano
authors.affiliation: Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Papadimos
authors.affiliation: Department of Emergency Medicine, University of Florida, Jacksonville, Ohio, USA.
authors.forename: Sagar C
authors.initials: SC
authors.lastname: Galwankar
authors.affiliation: Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Pappada
authors.affiliation: Division of Performance Assessment & Augmentation, Aptima, Inc., Fairborn, Ohio, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Feeney
authors.affiliation: Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Evans
keywords: Comorbidity-polypharmacy score; elderly trauma patient; estimation of frailty; multimorbidity; physiologic age; public health; world demographics