General Medicine A

Charlson Comorbidity Index (CCI) — Detailed

Detailed 17-condition comorbidity index predicting 10-year mortality. Age-adjusted version adds 1 point per decade after age 50.

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)*

Diabetes (without end-organ damage)*

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

Hemiplegia*

Moderate/severe renal disease (eGFR <30 or dialysis)*

Any solid tumour (not metastatic, within last 5 years)*

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

Metastatic solid tumour*

AIDS (not just HIV positive)*

Score interpretation

Low Comorbidity 0–1

CCI 0–1. Low burden of comorbidity. Predicted 10-year survival ~98%.

→ Standard clinical care. Annual review.

Moderate Comorbidity 2–3

CCI 2–3. Moderate comorbidity. Predicted 10-year survival ~53%.

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

High Comorbidity 4–5

CCI 4–5. High comorbidity burden. Predicted 10-year survival ~21%.

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

Very High Comorbidity 6–40

CCI ≥6. Very high burden. Predicted 10-year survival <10%.

→ 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.

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

Drugs

Pathways

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