| Rating strategy of comorbidity | |
| Organ system not compromised | 0 = No problem |
| Illness/impairment with or without requirement of therapy, excellent prognosis, patient with normal activity | 1 = Mild |
| Illness/impairment requiring therapy, good prognosis, compromised activity | 2 = Moderate |
| Illness/impairment with urgent requirement of therapy, prognosis unclear, marked restriction in activity | 3 = Severe |
| Life threatening illness/impairment, emergency case of therapy, adverse prognosis | 4 = Extremely severe |
| Assess illness/impairment in each of the following systems on a scale from 1 to 4: | |
| System | Score |
| Heart | |
| Blood pressure | |
| Vascular | |
| Respiratory | |
| Eye/ear/nose/throat/larynx | |
| Upper gastrointestinal | |
| Lower gastrointestinal | |
| Liver | |
| Renal | |
| Genitourinary | |
| Musculoskeletal | |
| Endocrine/metabolic | |
| Neurological | |
| Psychiatric | |
| Total | |
