Clinical calculator summary
CRASH Chemotherapy Toxicity Score
Clinical calculator summary
CRASH Chemotherapy Toxicity Score
A geriatric oncology toxicity score estimating severe chemotherapy toxicity in older adults.
Evidence-based context for fast calculator use
- Purpose:
- Support chemotherapy toxicity risk discussion and geriatric assessment planning
- Population:
- Older adults being considered for chemotherapy
- Factors:
- Chemotox regimen risk, Diastolic blood pressure, IADL, LDH, ECOG, MMSE, MNA
- Reference:
- Extermann et al., Cancer 2012
CRASH Chemotherapy Toxicity Score
Clinical Context & Background
Combined CRASH score = Chemotox category + hematologic predictors + nonhematologic predictors, counting Chemotox once. Hematologic subscore includes Chemotox, diastolic BP, IADL, and LDH. Nonhematologic subscore includes Chemotox, ECOG, MMSE, and MNA.Reference Data
| Combined Score | Risk Category |
|---|---|
| 0 - 3 | Low |
| 4 - 6 | Intermediate-low |
| 7 - 9 | Intermediate-high |
| > 9 | High |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use CRASH Chemotherapy Toxicity Score when chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) for severe chemotherapy toxicity risk in older adults.
- Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.
How To Interpret
- Interpret the displayed result using the calculator-specific formula and reference table, spanning 0 - 3 through > 9.
- A boundary result should prompt input verification and clinical review rather than false precision.
What To Do Next
- Review function, cognition, nutrition, comorbidity, medicines, falls, social support, treatment goals, and modifiable risks.
- Document the inputs, result, timing, and clinical context so the assessment can be reproduced.
Limitations
- Geriatric tools support individualized mitigation and do not define frailty or treatment eligibility alone.
- The result supports clinician judgment and does not independently determine treatment.
Validated Population
older adults with cancer being assessed for vulnerability or treatment toxicity
How to apply this result
For a representative case, verify Chemotherapy regimen toxicity risk, Diastolic blood pressure >72 mmHg?, IADL score 10-25?, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.
Related Tools
Frequently Asked Questions
What is Chemotox in the CRASH score?
Chemotox represents chemotherapy regimen toxicity risk. The original CRASH model used an index based on regimen-level toxicity estimates. If uncertain, confirm with oncology pharmacy or use the most conservative plausible category.
How is CRASH different from CARG?
CRASH separates hematologic and nonhematologic toxicity predictors and explicitly incorporates regimen toxicity risk. CARG is often simpler to collect in routine practice.
Evidence-based oncology decision support. Verify with clinical guidelines.