Charlson Comorbidity Index Calculator

Created by Joanna Michałowska, PhD candidate and Dominika Śmiałek, MD, PhD candidate
Reviewed by Bogna Szyk and Jack Bowater
Based on research by
Charlson, M. E.; Pompei, P.; Ales, K. L.; MacKenzie, C. R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation Journal of chronic diseases (1987)
Last updated: Jul 25, 2022

The Charlson Comorbidity Index calculator estimates survival in patients with multiple comorbidities. It consists of 17 items that are related to various health conditions that are associated with mortality. The Charlson index can predict short- and long-term outcomes, including function, length of hospitalization, and mortality rates. Check the article below to find out how to calculate the Charlson Comorbidity Index score.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace professional medical advice.

What is Charlson Index?

The Charlson Comorbidity Index was developed in 1987 by Charlson and colleagues as a way to classify comorbid conditions which may influence mortality risk. This tool was originally supposed to be used in longitudinal studies. The initial Charlson Index was created using 19 categories but has been modified since to contain 17 or 12 items. Nowadays, the CCI is one of the most widely used scoring systems for comorbidities used in research and clinical settings.

How to calculate Charlson Comorbidity Index

The Charlson Comorbidity Index calculator consists of 17 items. Each item can be scored from 0 to 6 points, and each has a different weight (which is based on the strength of the item's association with 1-year mortality, as presented in the paper by Charles et al.). This is why some variables can score only 1 point at most (e.g. history of the myocardial infarction), while others can score as many as 6 points (e.g. metastatic tumor).

The table below shows how many points each item scores.

Comorbidity

Score

Myocardial infarction

+ 1

Congestive heart failure

+ 1

Peripheral vascular disease

+ 1

Cerebrovascular disease

+ 1

Dementia

+ 1

Chronic pulmonary disease

+ 1

Rheumatologic disease

+ 1

Peptic ulcer disease

+ 1

Liver disease

+ 1 if mild, + 3 if moderate/severe

Diabetes

+ 1 if controlled, + 2 if uncontrolled

Hemiplegia or paraplegia

+ 2

Renal disease

+ 2

Malignancy

+ 2 if localized, + 6 if metastatic tumor

Leukemia

+ 2

Lymphoma

+ 2

AIDS

+ 6

Additional information:

  • If the comorbidity is not present, patients score 0 points for that comorbidity.
  • Patients who are 50 years old or more should get additional points as follows:
    • 50-59 years old - additional 1 point;
    • 60-69 years old - additional 2 points;
    • 70-79 years old - additional 3 points; and
    • 80 years old or more - additional 4 points.

Charlson Comorbidity Index score

The maximum Charlson Comorbidity Index score (adjusted for age) is 37 points.
After scoring each comorbidity, the patient's 10-year survival rate can be calculated. It is estimated using a theoretical low-risk population, whose 10-year survival is 98.3%. The formula is:

10-y survival = 0.983^(eCCI*0.9)

where:

  • e - Euler's number, the mathematical constant that is equal to approx. 2.71828; and

  • CCI - the Charlson Comorbidity Index score adjusted for age.

Charlson Comorbidity Index calculator - a practical example

Let's use a practical example to show you how to calculate Charlson Comorbidity Index.

  1. Characteristics of our exemplary patient:
  • Age: 57 years old;
  • Comorbidities: diabetes controlled with medication, myocardial infarction (heart attack) 5 years ago; and
  • Patient does not report any other health conditions.
  1. Charlson Comorbidity Index score of our patient equals 3:
  • +1 point for the age between 50 and 59;
  • +1 point for controlled diabetes; and
  • +1 point for the history of myocardial infarction.
  1. Finally, we can calculate 10-year survival for this patient as follows:

    10-y survival = 0.983^(eCCI*0.9)

    10-y survival = 0.983^(2.718283*0.9)

    10-y survival = 0.983^(2.718282.7)

    10-y survival = 0.98314.88

    10-y survival = 0.7748 = 77.48%

Joanna Michałowska, PhD candidate and Dominika Śmiałek, MD, PhD candidate
Age of the patient
<50 years
Myocardial infarction
No
Congestive heart failure
No
Peripheral vascular disease
No
Cerebrovascular disease
No
Dementia
No
Chronic pulmonary disease
No
Rheumatologic disease
No
Peptic ulcer disease
No
Liver disease
No
Diabetes
No
Hemiplegia or paraplegia
No
Renal disease
No
Malignancy
No
Leukemia
No
Lymphoma
No
AIDS
No
Results
CCI score
points
Estimated 10-year survival
%
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