General Medicine A

Charlson Comorbidity Index (CCI) — Detailed

Charlson comorbidity index with age adjustment: 19 weighted conditions plus 1 point per decade from age 50 (maximum 4), with the estimated 10-year survival.

Age Adjustment*

Myocardial infarction (history)*

Congestive heart failure*

Peripheral vascular disease*

Cerebrovascular disease (CVA or TIA)*

Dementia*

Chronic pulmonary disease (COPD, asthma)*

Connective tissue disease (RA, SLE, polymyositis)*

Peptic ulcer disease*

Mild liver disease (cirrhosis without portal hypertension, chronic hepatitis) (not added if moderate/severe liver disease is ticked)*

Diabetes without end-organ damage (not added if end-organ damage is ticked)*

Diabetes with end-organ damage (retinopathy, neuropathy, nephropathy)*

Hemiplegia*

Moderate/severe renal disease (creatinine > 265 µmol/L [3 mg/dL], dialysis, transplant or uraemia)*

Solid tumour, not metastatic, within last 5 years (not added if metastatic tumour is ticked)*

Leukaemia*

Lymphoma (including myeloma)*

Moderate/severe liver disease (portal hypertension, oesophageal varices)*

Metastatic solid tumour*

AIDS (not just HIV positive)*

Score interpretation

CCI 0–1 — Estimated 10-Year Survival 96–98% 0–1

Age-adjusted CCI 0–1: estimated 10-year survival 98% (0) and 96% (1).

→ Standard clinical care. Annual review.

CCI 2–3 — Estimated 10-Year Survival 77–90% 2–3

Age-adjusted CCI 2–3: estimated 10-year survival 90% (2) and 77% (3).

→ Multimorbidity management. Review polypharmacy. Patient-centred care planning.

CCI 4–5 — Estimated 10-Year Survival 21–53% 4–5

Age-adjusted CCI 4–5: estimated 10-year survival 53% (4) and 21% (5).

→ Comprehensive geriatric/multimorbidity assessment. Advance care planning. Minimise treatment burden.

CCI ≥ 6 — Estimated 10-Year Survival ≤ 2% 6–41

Age-adjusted CCI ≥ 6: estimated 10-year survival 2% or less.

→ Palliative care consideration. Advance care planning urgently. Focus on quality of life and patient-defined goals.

Interpretation bands for the CCI Detailed. Apply clinical judgement and local guidance.

References

Charlson ME et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.
Quan H et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676-682.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Cumulative Illness Rating Scale — Geriatric (CIRS-G)Recommended
Comorbidity Assessment

Same class

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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