Charlson comorbidity index (Quan 2011)

Hude Quan, Bing Li, Chantal M. Couris, Kiyohide Fushimi, Patrick Graham, Phil Hider, Jean-Marie Januel, Vijaya Sundararajan

PH1657 / 3432 Clinical-Coded Phenotype

  1. Overview

    Phenotype Type
    Disease or syndrome
    Sex
    Both
    Valid Event Date Range
    No data
    Coding System
    ICD10 codes
    Data Sources
    Hospital Episode Statistics Admitted Patient Care
    Collections
    BHF Data Science Centre
    Tags
    Comorbidity Index

  2. Definition

    The Charlson comorbidity index (CCI), modified by Quan et al., includes comorbidities used to predict mortality risk and healthcare utilisation. The updated index of 12 comorbidities (17 when stratified by severity) showed good-to-excellent discrimination in predicting in-hospital mortality in data from 6 countries and may be appropriate for use with more recent administrative data.

    ICD-10 codes and condition weightings were obtained from the source code of the "comorbidity" R package.

    References

    • Hude Quan, Bing Li, Chantal M. Couris, Kiyohide Fushimi, Patrick Graham, Phil Hider, Jean-Marie Januel, Vijaya Sundararajan, Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 Countries, American Journal of Epidemiology, Volume 173, Issue 6, 15 March 2011, Pages 676–682, https://doi.org/10.1093/aje/kwq433

    • Gasparini, (2018). comorbidity: An R package for computing comorbidity scores. Journal of Open Source Software, 3(23), 648, https://doi.org/10.21105/joss.00648

  3. Implementation

    Implementation

    CCI Scoring System

    The conditions have the following weightings:

    1. Myocardial infarction: 0

    2. Congestive heart failure: 2

    3. Peripheral vascular disease: 0

    4. Cerebrovascular disease: 0

    5. Dementia: 2

    6. Chronic pulmonary disease: 1

    7. Rheumatologic disease: 1

    8. Peptic ulcer disease: 0

    9. Hemiplegia/ paraplegia: 2

    10. Diabetes without complications: 0

    11. Diabetes with chronic complications: 1

    12. Mild liver disease: 2

    13. Moderate/severe liver disease: 4

    14. Renal disease: 1

    15. Malignancy (tumor, leukemia, lymphoma): 2

    16. Metastatic solid tumor: 6

    17. HIV/AIDS: 4

    Hierarchy Categories

    Within each hierarchy category, the milder condition should not contribute to the CCI score if a more severe condition is present, even though codes for both may appear for an individual patient.

    1. "Diabetes with chronic complications" (Condition 11) trumps "Diabetes without complications" (Condition 10)

    2. "Moderate/severe liver disease" (Condition 13) trumps "Mild liver disease" (Condition 12)

    3. "Metastatic solid tumor" (Condition 16) trumps "Malignancy" (Condition 15)

  4. Clinical Code List

  5. Publication

    • 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 Mar 15;173(6):676-82. doi: 10.1093/aje/kwq433. Epub 2011 Feb 17. PMID: 21330339.

      (DOI:10.1093/aje/kwq433)

    • Gasparini, (2018). comorbidity: An R package for computing comorbidity scores. Journal of Open Source Software, 3(23), 648, https://doi.org/10.21105/joss.00648

      (DOI:10.21105/joss.00648)

    • Hedetoft M, Madsen MB, Madsen LB, et alIncidence, comorbidity and mortality in patients with necrotising soft-tissue infections, 2005–2018: a Danish nationwide register-based cohort studyBMJ Open 2020;10:e041302. doi: 10.1136/bmjopen-2020-041302

      (DOI:10.1136/bmjopen-2020-041302)

    Citation Requirements

    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 Mar 15;173(6):676-82. doi: 10.1093/aje/kwq433. Epub 2011 Feb 17. PMID: 21330339.

    Citation Example

    Hude Quan, Bing Li, Chantal M. Couris, Kiyohide Fushimi, Patrick Graham, Phil Hider, Jean-Marie Januel, Vijaya Sundararajan. PH1657 / 3432 - Charlson comorbidity index (Quan 2011). Phenotype Library [Online]. 25 June 2024. Available from: http://phenotypes.healthdatagateway.org/phenotypes/PH1657/version/3432/detail/. [Accessed 08 October 2024]

  6. API

    To Export Phenotype Details:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH1657/version/3432/detail/?format=json
    R Package

    # Download here

    library(ConceptLibraryClient)


    # Connect to API

    client = ConceptLibraryClient::Connection$new(public=TRUE)


    # Get details of phenotype

    phenotype_details = client$phenotypes$get_detail(
     'PH1657',
     version_id=3432
    )

    Py Package

    # Download here

    from pyconceptlibraryclient import Client


    # Connect to API

    client = Client(public=True)


    # Get codelist of phenotype

    phenotype_codelist = client.phenotypes.get_detail(
     'PH1657',
     version_id=3432
    )

    To Export Phenotype Code List:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH1657/version/3432/export/codes/?format=json
    CSV site_root/phenotypes/PH1657/version/3432/export/codes/
    R Package

    # Download here

    library(ConceptLibraryClient)


    # Connect to API

    client = ConceptLibraryClient::Connection$new(public=TRUE)


    # Get codelist of phenotype

    phenotype_codelist = client$phenotypes$get_codelist(
     'PH1657',
     version_id=3432
    )

    Py Package

    # Download here

    from pyconceptlibraryclient import Client


    # Connect to API

    client = Client(public=True)


    # Get codelist of phenotype

    phenotype_codelist = client.phenotypes.get_codelist(
     'PH1657',
     version_id=3432
    )

  7. Version History

    Version IDNameOwnerPublish date
    3432 Charlson comorbidity index (Quan 2011) farrellj2024-06-26currently shown