Charlson comorbidity index (Charlson 1987)

Mary E. Charlson, Peter Pompei, Kathy L. Ales, C. Ronald MacKenzie

PH1658 / 3431 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), includes comorbidities used to predict mortality risk and healthcare utilisation. The index is composed 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

    • Charlson, M.E. et al. (1987) ‘A new method of classifying prognostic comorbidity in Longitudinal Studies: Development and validation’, Journal of Chronic Diseases, 40(5), pp. 373–383. doi:10.1016/0021-9681(87)90171-8.

    • 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: 1

    2. Congestive heart failure: 1

    3. Peripheral vascular disease: 1

    4. Cerebrovascular disease: 1

    5. Dementia: 1

    6. Chronic pulmonary disease: 1

    7. Rheumatologic disease: 1

    8. Peptic ulcer disease: 1

    9. Hemiplegia/ paraplegia: 2

    10. Diabetes without complications: 1

    11. Diabetes with chronic complications: 2

    12. Mild liver disease: 1

    13. Moderate/severe liver disease: 3

    14. Renal disease: 2

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

    16. Metastatic solid tumor: 6

    17. HIV/AIDS: 6

    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

    • Charlson, M.E. et al. (1987) ‘A new method of classifying prognostic comorbidity in Longitudinal Studies: Development and validation’, Journal of Chronic Diseases, 40(5), pp. 373–383. doi:10.1016/0021-9681(87)90171-8.

      (DOI:10.1016/0021-9681(87)90171-8)

    • 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)

    Citation Requirements

    Charlson, M.E. et al. (1987) ‘A new method of classifying prognostic comorbidity in Longitudinal Studies: Development and validation’, Journal of Chronic Diseases, 40(5), pp. 373–383. doi:10.1016/0021-9681(87)90171-8.

    Citation Example

    Mary E. Charlson, Peter Pompei, Kathy L. Ales, C. Ronald MacKenzie. PH1658 / 3431 - Charlson comorbidity index (Charlson 1987). Phenotype Library [Online]. 25 June 2024. Available from: http://phenotypes.healthdatagateway.org/phenotypes/PH1658/version/3431/detail/. [Accessed 01 December 2024]

  6. API

    To Export Phenotype Details:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH1658/version/3431/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(
     'PH1658',
     version_id=3431
    )

    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(
     'PH1658',
     version_id=3431
    )

    To Export Phenotype Code List:

    FormatAPI
    JSON site_root/api/v1/phenotypes/PH1658/version/3431/export/codes/?format=json
    CSV site_root/phenotypes/PH1658/version/3431/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(
     'PH1658',
     version_id=3431
    )

    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(
     'PH1658',
     version_id=3431
    )

  7. Version History

    Version IDNameOwnerPublish date
    3431 Charlson comorbidity index (Charlson 1987) farrellj2024-06-26currently shown