Charlson Comorbidity Index (CCI) Online Calculator

Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

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History of definite or probable MI (EKG changes and/or enzyme changes)

Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents

Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)

History of a cerebrovascular accident with minor or no residua and transient ischemic attacks

Chronic cognitive deficit

Any history of treatment for ulcer disease or history of ulcer bleeding

Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)

Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)


* Required


VariablePoints
Age 
<50 years0
50–59 years+1
60–69 years+2
70–79 years+3
≥80 years+4
Myocardial infarction
History of definite or probable MI (EСG changes and/or enzyme changes)
+1
Congestive heart failure
Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents
+1
Peripheral vascular disease
Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)
+1
Cerebrovascular accident  or Transient ischemic attack
History of a cerebrovascular accident with minor or no residua and transient ischemic attacks
+1
Dementia
Chronic cognitive deficit
+1
Chronic obstructive pulmonary disease+1
Connective tissue disease+1
Peptic ulcer disease
Any history of treatment for ulcer disease or history of ulcer bleeding
+1
Liver disease
Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)
None 0
 Mild +1
 Moderate to severe +3
Diabetes mellitusNone or diet-controlled 0
 Uncomplicated +1
 End-organ damage +2
Hemiplegia+2
Moderate to severe chronic kidney disease
Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)
+2
  
Solid tumorNone 0
 Localized +2
 Metastatic +6
Leukemia+2
Lymphoma+2
AIDS+6

Charlson Comorbidity Index assess by addition of the selected points:

VariableDefinitionPoints
Myocardial infarctionHistory of definite or probable MI (EKG changes and/or enzyme changes)1
Congestive heart failureExertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents1
Peripheral vascular diseaseIntermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)1
Cerebrovascular accident or transient ischemic attackHistory of a cerebrovascular accident with minor or no residua and transient ischemic attacks1
DementiaChronic cognitive deficit1
Chronic obstructive pulmonary disease1
Connective tissue disease1
Peptic ulcer diseaseAny history of treatment for ulcer disease or history of ulcer bleeding1
Mild liver diseaseMild = chronic hepatitis (or cirrhosis without portal hypertension)1
Uncomplicated diabetes1
Hemiplegia2
Moderate to severe chronic kidney diseaseSevere = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)2
Diabetes with end-organ damage2
Localized solid tumor2
Leukemia2
Lymphoma2
Moderate to severe liver diseaseSevere = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history3
Metastatic solid tumor6
AIDS*6

Plus 1 point for every decade age 50 years and over, maximum 4 points.

Note: liver disease and diabetes inputs are mutually exclusive (e.g. do not give points for both “mild liver disease” and “moderate or severe liver disease”).

*This data is from the original Charlson study in 1987, before the widespread availability of effective antiretroviral therapy. Currently, there are no any re-evaluations of the CCI using more recent data.

10-year survival = 0.983^(e CCI × 0.9), where CCI = Charlson Comorbidity Index.


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Literature:

  1. Charlson ME, Pompei P, Ales KL, MacKenzie CR: A New Method of Classifying Prognostic Comorbidity in Longitudinal Studies: Development and Validation. Journal of Chronic Diseases 40:373-383, 1987
  2. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V. 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)doi: 10.1093/aje/kwq433
  3. Radovanovic D, Seifert B, Urban P, Eberli FR, Rickli H, Bertel O, Puhan MA, Erne P; AMIS Plus Investigators. Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002-2012. Heart. 2014 Feb;100(4):288-94. doi: 10.1136/heartjnl-2013-304588. Epub 2013 Nov 1.
  4. Zavascki AP, Fuchs SC. The need for reappraisal of AIDS score weight of Charlson comorbidity index. J Clin Epidemiol. 2007;60(9):867-8.

Multiple Myeloma Diagnostic Criteria – Online Calculator

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≥1 of the following (A or B)

≥1 myeloma defining event (C1 or C2)


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