Charlson Comorbidity Index: Difference between revisions

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==Structure==

~~Contains '''19 primary~~ medical conditions''' of comorbidity some of which contain subcategories of diseases related to the primary category. For a list of all diagnosis applicable that we use go to: [[:Category: Charlson Comorbid Diagnosis | Charlson Comorbid Diagnosis]] (or [[Charlson Comorbid coding (pre ICD10)#Comorbid_List]] as former may not include all sub-diagnoses).

*The CCI takes account of 17 chronic medical conditions

== ~~ICD10~~ ==

*Each of the 17 items has a certain number of points, and the total score is the sum of all of them.

~~See~~

**There is one tricky thing about the scoring though:

* [[Charlson Comorbidities in ICD10 codes]]

***Of the 17 there are two are mutually exclusive pairs: (a) Diabetes Mellitus with and without chronic complications, and (b) Liver disease as mild vs. moderate/severe. If you should qualify for both members of a pair, then only count the points for the more severe (higher scoring). Example: if you have diagnoses that qualify you for both mild liver disease and moderate/severe liver disease, only include the points from the latter.

* [[Charlson Comorbidity scoring in ICD10 codes]]

*For a list of all diagnosis applicable that we use go to: [[:Category: Charlson Comorbid Diagnosis | Charlson Comorbid Diagnosis]] (or [[Charlson Comorbid coding (pre ICD10)#Comorbid_List]] as former may not include all sub-diagnoses).

== Derivation ==

* the actual score: [[query Charlson_Score_pre_and_ICD10]]

* ICD10 (includes all admission having [[Dispo DtTm]] starting Jan 1, 2019)

** [[Charlson Comorbidities in ICD10 codes]]

** [[Charlson Comorbidity scoring in ICD10 codes]]

* pre-ICD10 (includes all admissions having [[Dispo DtTm]] before Jan 1, 2019)

** [[Charlson Comorbidity scoring in pre-ICD10 codes]]

=== We do not include an age factor ===

The original Charlson paper optionally mentions an age factor. We do not use it. Confirmed with Dr. Garland and Dr. Roberts 2025-06-19.

{{Todo

| who = Tina

| todo_added = 2025-06-19

| todo_action = 2025-06-19

| question =

* I need to confirm this is not in any of our VBA code or queries

* I implemented it in CCMDB (not CFE for some reason) "L_ICD10_Charlson_Agepts" query.

}}

== Data Use ==

* [[ALERT Scale]] score for Medicine

* Some items are use for [[APACHE II]] score for Critical Care. For a specific list of chronic condition applicable to APACHE II scoring see: [[Chronic Health APACHE]]

* Medicine [[Quarterly report]] and Fiscal Year Reports {{discuss | who = Julie |question = Is that the [[Annual report]]?}}

* the dxs involved were also used in [[Overstay]]

== Background ==

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=== Article and related publications ===

* "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" ME Charlson

**[http://www.aqc.ch/download/HSM_Suppl_8_charlson.pdf PDF of article] (also: A PDF of the complete original article can be found on- ~~[[X~~:\]]CCMDB_ADMIN_DATABASE\Charlson_Comorbids\OriginalCharlsonArticlePDF)

**[http://www.aqc.ch/download/HSM_Suppl_8_charlson.pdf PDF of article] (also: A PDF of the complete original article can be found on- {{S:\MED\MED_CCMED}}CCMDB_ADMIN_DATABASE\Charlson_Comorbids\OriginalCharlsonArticlePDF)

**[[Media:Charlson ii article page 2 19 items with points.JPG | image of Charlson article, page 2]].

*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC545968/ Article: An electronic application for rapidly calculating Charlson comorbidity score]. Article with link to a comorbid score calculator developed in MS Excel using a macro.

**Copy of this calculator can be found: X:\CCMDB_ADMIN_DATABASE\Charlson_Comorbids\comorbid calculator

**Copy of this calculator can be found: {{S:\MED\MED_CCMED}}CCMDB_ADMIN_DATABASE\Charlson_Comorbids\comorbid calculator

*[[Media:Quan2005.pdf | "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data" Hude Quon]]

@@ Line 11: / Line 11: @@
 ==Structure==
-Contains '''19 primary medical conditions''' of comorbidity some of which contain subcategories of diseases related to the primary category.  For a list of all diagnosis applicable that we use go to: [[:Category: Charlson Comorbid Diagnosis | Charlson Comorbid Diagnosis]] (or [[Charlson Comorbid coding (pre ICD10)#Comorbid_List]] as former may not include all sub-diagnoses).
+*The CCI takes account of 17 chronic medical conditions
-== ICD10 ==
+*Each of the 17 items has a certain number of points, and the total score is the sum of all of them.
-See
+**There is one tricky thing about the scoring though:
-* [[Charlson Comorbidities in ICD10 codes]]
+***Of the 17 there are two are mutually exclusive pairs: (a) Diabetes Mellitus with and without chronic complications, and (b) Liver disease as mild vs. moderate/severe. If you should qualify for both members of a pair, then only count the points for the more severe (higher scoring).  Example:  if you have diagnoses that qualify you for both mild liver disease and moderate/severe liver disease, only include the points from the latter.
-* [[Charlson Comorbidity scoring in ICD10 codes]]
+*For a list of all diagnosis applicable that we use go to: [[:Category: Charlson Comorbid Diagnosis | Charlson Comorbid Diagnosis]] (or [[Charlson Comorbid coding (pre ICD10)#Comorbid_List]] as former may not include all sub-diagnoses).
+== Derivation ==
+* the actual score: [[query Charlson_Score_pre_and_ICD10]]
+* ICD10 (includes all admission having [[Dispo DtTm]] starting Jan 1, 2019)
+** [[Charlson Comorbidities in ICD10 codes]]
+** [[Charlson Comorbidity scoring in ICD10 codes]]
+* pre-ICD10 (includes all admissions having [[Dispo DtTm]] before Jan 1, 2019)
+** [[Charlson Comorbidity scoring in pre-ICD10 codes]]
+=== We do not include an age factor ===
+The original Charlson paper optionally mentions an age factor. We do not use it. Confirmed with Dr. Garland and Dr. Roberts 2025-06-19.
+{{Todo
+ | who = Tina
+ | todo_added = 2025-06-19
+ | todo_action = 2025-06-19
+ | question =
+* I need to confirm this is not in any of our VBA code or queries
+* I implemented it in CCMDB (not CFE for some reason) "L_ICD10_Charlson_Agepts" query.
+ }}
 == Data Use ==
 * [[ALERT Scale]] score for Medicine
 * Some items are use for [[APACHE II]] score for Critical Care.  For a specific list of chronic condition applicable to APACHE II scoring see:  [[Chronic Health APACHE]]
-* Medicine [[Quarterly report]] and Fiscal Year Reports {{discuss | who = Julie |question = Is that the [[Annual report]]?}}
-* the dxs involved were also used in [[Overstay]]
 == Background ==
@@ Line 35: / Line 53: @@
 === Article and related publications ===
 * "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" ME Charlson
-**[http://www.aqc.ch/download/HSM_Suppl_8_charlson.pdf PDF of article] (also: A PDF of the complete original article can be found on- [[X:\]]CCMDB_ADMIN_DATABASE\Charlson_Comorbids\OriginalCharlsonArticlePDF)
+**[http://www.aqc.ch/download/HSM_Suppl_8_charlson.pdf PDF of article] (also: A PDF of the complete original article can be found on- {{S:\MED\MED_CCMED}}CCMDB_ADMIN_DATABASE\Charlson_Comorbids\OriginalCharlsonArticlePDF)
 **[[Media:Charlson ii article page 2 19 items with points.JPG | image of Charlson article, page 2]].
 *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC545968/ Article:  An electronic application for rapidly calculating Charlson comorbidity score].  Article with link to a comorbid score calculator developed in MS Excel using a macro.
-**Copy of this calculator can be found: X:\CCMDB_ADMIN_DATABASE\Charlson_Comorbids\comorbid calculator
+**Copy of this calculator can be found: {{S:\MED\MED_CCMED}}CCMDB_ADMIN_DATABASE\Charlson_Comorbids\comorbid calculator
 *[[Media:Quan2005.pdf | "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data" Hude Quon]]