Charlson Comorbidity Index
In medicine, the Charlson Comorbidity Index (CCI) predicts the mortality for a patient who may have a range of concurrent conditions (comorbidities), such as heart disease, AIDS, or cancer (considering a total of 17 categories).[1] A score of zero means that no comorbidities were found; the higher the score, the higher the predicted mortality rate is.[2][3] For a physician, this score is helpful in deciding how aggressively to treat a condition.
It is one of the most widely used scoring system for comorbidities.[4] The index was developed by Mary Charlson and colleagues in 1987, but the methodology has been adapted several times since then based on the findings of additional studies.[5] Many variations of the Charlson comorbidity index have been presented, including the Charlson/Deyo, Charlson/Romano, Charlson/Manitoba, and Charlson/D'Hoores comorbidity indices.
Calculation
Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Clinical conditions and associated scores are as follows:
- 1 each: rheumatologic disease, peptic ulcer disease, liver disease (if mild, or 3 if moderate/severe), diabetes(if controlled, or 2 if uncontrolled)
- 2 each:
- 6 each: AIDS
Patients who are 50 years old or more get additional points:[6]
- 50-59 years old: +1 point
- 60-69 years old: +2 points
- 70-79 years old: +3 points
- 80 years old or more: +4 points
Scores are summed to provide a total score to predict mortality.
Currently 17 categories are considered in the popular Charlson/Deyo variant,[7] instead of 19 in the original score.[8] The weights were also adapted in 2003.[9]
Conditions can be identified using the International Classification of Diseases (ICD) diagnosis codes commonly used in patient records.
Use
For a physician, this score is helpful in deciding how aggressively to treat a condition. For example, a patient may have cancer with comorbid heart disease and diabetes. These comorbidities may be so severe that the costs and risks of cancer treatment would outweigh its short-term benefit.
Since patients often do not know how severe their conditions are, nurses were originally supposed to review a patient's chart and determine whether a particular condition was present in order to calculate the index. Subsequent studies have adapted the comorbidity index into a questionnaire for patients.
The Charlson index, especially the Charlson/Deyo, followed by the Elixhauser have been most commonly referred by the comparative studies of comorbidity and multimorbidity measures.[10]
See also
References
- PMID 3558716.
- S2CID 245802035.
- PMID 34556689.
- ^ Figueiredo S (3 March 2009). Zeltzer L, Korner-Bitensky N, Sitcoff E (eds.). "Charlson Comorbidity Index (CCI) – Strokengine". Retrieved 2023-03-25.
- ^ "Concept: Charlson Comorbidity Index". mchp-appserv.cpe.umanitoba.ca. Retrieved 2023-03-25.
- PMID 31870318.
- PMID 1607900.
- ^ "Charlson Comorbidity Index Calculator". www.omnicalculator.com. Retrieved 2023-03-25.
- PMID 12968819.
- S2CID 25852524.