Charlson Comorbidity Index (CCI)

Addition of the selected points: Variable Definition Points Myocardial infarction History of definite or probable MI (EKG 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 pulmonary disease - 1 Connective tissue disease - 1 Peptic ulcer disease Any history of treatment for ulcer disease or history of ulcer bleeding 1 Mild liver disease Mild = chronic hepatitis (or cirrhosis without portal hypertension) 1 Uncomplicated diabetes - 1 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 Diabetes with end-organ damage - 2 Localized solid tumor - 2 Leukemia - 2 Lymphoma - 2 Moderate to severe liver disease Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history 3 Metastatic solid tumor - 6 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. We are not aware of any re-evaluations of the CCI using more recent data.