CHARLSON COMORBIDITY INDEX (CCI)
Ageyrs. Serum Albuming/dL LLA* g/dL. Conversion factor: conversion_factor CCI ____
SURVIVAL	1 YEAR	2 YEAR
Survival (CCI)	__	__
Survival (Alb)	__	__
Survival (Alb & CCI)	__	__

___

One Point

• Myocardial infarction (history, not ECG changes only)
• Congestive heart failure
• Peripheral disease (includes aortic aneurysm >= 6 cm
• Cerebrovascular disease: CVA with mild or no residua or TIA
• Dementia
• Chronic pulmonary disease
• Connective tissue disease
• Peptic ulcer disease
• Mild liver disease (without portal hypertension, inlcudes chronic hepatitis)
• Diabetes without end-organ damage (excludes diet-controlled alone)

Two Points

• Hemiplegia
• Moderate or severe renal disease
• Diabetes with end-organ damage (retinopathy, neuropathy,nephropathy, or brittle diabetes)
• Tumor without metastasis (exclude if > 5 yr from diagnosis)
• Leukemia(acute or chronic)
• Lymphoma

Three Points

• Moderate or severe liver disease

Six Points

• Metastatic solid tumor
• AIDS (not just HIV positive)

*Nephrologists will need to enter the lower limit of albumin (LLA) if it is less than 3.5 g/dL. This program will autoadjust the patient’s serum albumin level for the normal range for the serum albumin assay based upon the LLA entered above. The program will multiply the level by a default correction factor of 3.5/LLA. If different, please correct in the box provided: