63 CARING criteria
Population: Criteria on day of admission to acute care hospital
Caring criteria components:
| Letter(s) | Meaning | Extra Notes |
| C | Primary Diagnosis of Cancer | Cancer diagnosis is primary reason for admission including admission for chemoRx |
| A | Admitted to the hospital 2 or more times in the past year for the same chronic illness or complication of that illness | None |
| R | Resident in a Long-Term Care or Skilled Nursing Facility (Nursing Home) | None |
| I | ICU admission with Multiple Organ System Failure (MOF) | MOF = any two or more of the following
|
| NG | Presence of two or more items from one category of non-cancer hospice guidelines | See below for details |
Renal
- Stop/decline dialysis
- Not transplant candidate
- Urine output < 40ml/24 hours
- Creatinine > 8.0
- Creatinine clearance 10 ml/min or less
- Uremia
- Persistent K+ > 7.0
- One or more comorbid conditions:
- Cancer
- Congestive Heart Failure
- Chronic Lung Disease
- Sepsis
- Cirrhosis
- HIV/AIDS
Dementia
- Unable to ambulate independently
- Urinary or fecal incontinence
- Unable to speak with more than single words
- Unable to bathe independently
- Unable to dress independently
- One or more comorbid conditions:
- Aspiration pneumonitis
- Pyelonephritis
- Decubitus ulcer
- Difficulty swallowing or refusal to eat
Cardiac
- Ejection Fraction < 20%
- Symptoms despite diuretic/vasodilator
- Not transplant candidate
- History of cardiac arrest
- History of syncope
- Systolic BP < 120
- CVA of cardiac origin
- One or more comorbid conditions:
- Cancer
- Chronic Lung Disease
- Sepsis
- Cirrhosis
- HIV/AIDS
Pulmonary
- Dyspnea at rest
- FEV1 < 30%
- Frequent ER or hospital admits for pulmonary infection or respiratory distress
- SaO2 < 88% on O2
- Cor pulmonale
- pCO2 > 50
- Resting tachycardia > 120
- One or more comorbid conditions:
- Cancer
- Congestive Heart Failure
- Sepsis
- Cirrhosis
- HIV/AIDS
Liver
- End-stage cirrhosis
- Not transplant candidate
- Protime > 5 sec and albumin <2.5
- Ascites unresponsive to treatment
- Hepatorenal syndrome
- Hepatic encephalopathy
- SBP
- Recurrent variceal bleed
- One or more comorbid conditions:
- Cancer
- CHF
- Chronic Lung Disease
- Sepsis
- Cirrhosis
- HIV/AIDS
Stroke/CVA
- Coma at onset
- Coma > 3 days duration
- Limb paralysis
- Urinary/fecal incontinence
- Impaired sitting balance
- KPS < 50%
- Recurrent aspiration
- Age > 70
- One or more comorbid conditions:
- Cancer
- CHF
- Chronic Lung Disease
- Sepsis
- Cirrhosis
- HIV/AIDS
HIV/AIDS
- Persistent decline in function
- Chronic diarrhea
- Decision to stop treatment
- CNS lymphoma
- Systemic lymphoma
- Dilated cardiomyopathy
- CD4 < 25 with disease progression
- Viral load > 100,000
Neuromuscular
- Diminished respiratory function
- Chosen not to receive BiPAP/MV
- Difficulty swallowing
- Diminished functional status
- Incontinence
- One or more comorbid conditions:
- Cancer
- CHF
- Chronic Lung Disease
- Sepsis
- Cirrhosis
- HIV/AIDS
Caring Criteria Components [or combination(s) of components] predicting 1-year mortality probability of 0.49 or greater (49 % or greater):
| Age Range | Letter(s) from CARING |
| Age < 55 | A and/or R Plus C and/or I and or NG |
| Age 55-65 |
|
| Age 66-75 |
|
| Age > 75 |
|
