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The Charlson Comorbidity Index (Charlson 1987) predicts one-year and ten-year mortality from a weighted count of 19 comorbidities (weights 1, 2, 3, and 6) plus an age adjustment (per decade over 40, 1994). Higher scores indicate greater comorbidity burden and lower estimated ten-year survival, with wide application as a case-mix adjustment in outcomes research and clinical prognostication.
CCI = sum of comorbidity weights (MI 1, CHF 1, PVD 1, CVD 1, dementia 1, COPD 1, connective tissue disease 1, peptic ulcer 1, mild liver disease 1, diabetes without complications 1; hemiplegia 2, moderate/severe renal disease 2, diabetes with end-organ damage 2, any malignancy 2, leukemia 2, lymphoma 2; moderate/severe liver disease 3; metastatic solid tumor 6, AIDS 6) + age adjustment (50–59 +1, 60–69 +2, 70–79 +3, ≥ 80 +4). Estimated 10-year survival = 0.983^(e^(0.9 × CCI)) × 100%.
0 = no comorbidity burden; 1–2 = low; 3–4 = moderate; ≥ 5 = high. Higher scores correspond to sharply lower estimated ten-year survival (e.g., 4 → ~53%, 5 → ~21%).
The Charlson Comorbidity Index was published by Mary Charlson and colleagues in 1987 as a method of classifying comorbid conditions to predict short-term (one-year) mortality. Nineteen conditions are assigned weights of 1, 2, 3, or 6 based on their adjusted relative risk of death; in the derivation cohort, one-year mortality rose from 12% at score 0 to 26% at 1–2, 52% at 3–4, and 85% at scores ≥ 5. In 1994 the index was age-adjusted by adding one point per decade over age 40, and an exponential model (10-year survival = 0.983^e^(0.9 × score)) was validated, yielding 10-year survivals of approximately 96%, 90%, 77%, 53%, and 21% for scores 1 through 5. The CCI is one of the most widely used comorbidity measures in clinical research.
Specialty
General MedicineCategory
Internal MedicineDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-16
Formula
Keywords
Normal Range
0 = no comorbidity burden; 1–2 = low; 3–4 = moderate; ≥ 5 = high. Higher scores correspond to sharply lower estimated ten-year survival (e.g., 4 → ~53%, 5 → ~21%).
| Classification | Range |
|---|---|
No comorbidity No significant comorbidity burden | 0 |
Low Low comorbidity burden | 1–2 |
Moderate Moderate comorbidity burden | 3–4 |
High High comorbidity burden | 5+ |
Quantifies comorbid disease burden from a weighted list of conditions plus age, providing an estimate of ten-year survival that supports prognosis, research adjustment, and treatment planning.
0 = no comorbidity burden; 1–2 = low; 3–4 = moderate; ≥ 5 = high. Estimated ten-year survival follows 0.983^e^(0.9 × score): ~96% at 1, ~90% at 2, ~77% at 3, ~53% at 4, ~21% at 5. The index predicts group outcomes, not individual survival.
The Charlson Comorbidity Index is the most widely used comorbidity measure in clinical research; its age-adjusted form provides a reproducible estimate of mortality risk that helps contextualize prognosis and adjust for case mix.
A 75-year-old man with prior myocardial infarction and congestive heart failure also has diabetes without end-organ damage.
Inputs:
CCI = 3 (MI 1 + CHF 1 + diabetes 1) + 3 (age 70–79) = 6 — HIGH comorbidity burden with an estimated ten-year survival of approximately 2%. This supports careful weighing of goals of care.
Use the age-adjusted CCI when estimating ten-year survival, since the exponential survival model was validated with the age adjustment included.
Because these conditions carried the highest relative risks of one-year mortality in the derivation cohort, so they receive the highest weight in the index.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. The CCI predicts population-level mortality risk and must not be used to forecast an individual patient's outcome or to make treatment decisions in isolation.