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)

Diabetes without end-organ damage

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

Hemiplegia

Moderate to severe renal disease

Solid tumour (without metastasis)

Leukaemia

Lymphoma

Moderate to severe liver disease (cirrhosis with portal hypertension)

Metastatic solid tumour

AIDS (not just HIV positive)

Score interpretation

No Comorbidity 0

CCI 0: Expected 10-year survival ~98% (age-adjusted)

→ Standard care; no comorbidity adjustment required

Low Comorbidity Burden 1–2

CCI 1–2: Expected 10-year survival ~89%

→ Routine monitoring of comorbidities; optimise chronic disease management

Moderate Comorbidity 3–4

CCI 3–4: Expected 10-year survival ~77%

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

High Comorbidity Burden 5–99

CCI ≥5: Expected 10-year survival ≤21%

→ 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.