General Medicine Surgery Oncology A

Charlson Comorbidity Index (CCI)

Predicts 10-year mortality based on comorbid conditions. Widely used for risk adjustment in research and clinical decision-making.

Myocardial infarction (history, not ECG changes only)*

Congestive heart failure*

Peripheral vascular disease (includes aortic aneurysm ≥6 cm)*

Cerebrovascular disease (CVA or TIA)*

Dementia*

Chronic pulmonary disease*

Connective tissue disease*

Peptic ulcer disease*

Mild liver disease (no portal hypertension, includes 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, or brittle)*

Hemiplegia*

Moderate to severe renal disease*

Solid tumour without metastasis (not added if metastatic solid tumour is ticked)*

Leukaemia*

Lymphoma*

Moderate to severe liver disease (cirrhosis with portal hypertension)*

Metastatic solid tumour*

AIDS (not just HIV positive)*

Score interpretation

No Comorbidity (CCI 0) 0

CCI 0 — 1-year mortality 12% in the derivation cohort (medical inpatients, Charlson 1987).

→ Standard care; no comorbidity adjustment required

Moderate Comorbidity (CCI 1–2) 1–2

CCI 1–2 — 1-year mortality 26% in the derivation cohort.

→ Routine monitoring of comorbidities; optimise chronic disease management

High Comorbidity (CCI 3–4) 3–4

CCI 3–4 — 1-year mortality 52% in the derivation cohort.

→ Multidisciplinary review; advance care planning discussion; optimise all comorbidities

Very High Comorbidity (CCI ≥ 5) 5–37

CCI ≥ 5 — 1-year mortality 85% in the derivation cohort.

→ Palliative care discussion; goals of care; frailty assessment; careful consideration of invasive interventions

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

Charlson ME, et al. A new method of classifying prognostic comorbidity in longitudinal studies. J Chronic Dis. 1987;40(5):373-383.

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.