Charlson Comorbidity Index
Assessing comorbid illnesses before treatment
The Charlson Index (Charlson Comorbidity Index, CCI) measures how much other illnesses you have may influence the course and the treatment of rectal cancer. Each condition is assigned a number of points according to its impact on prognosis. The version used here is the age-adjusted one (ACCI), because age itself is an independent factor.
Enter your age and tick only the conditions diagnosed by a doctor. If you are not sure about a condition, leave it unticked and ask your treating doctor.
Do not tick the rectal cancer you are being treated for. This score measures the illnesses you have alongside the rectal cancer. The "other solid tumour" section refers exclusively to a different cancer, other than the rectal one.
Complete preoperative assessment
The Charlson index describes comorbid illnesses. For the operative risk itself there is CR-POSSUM, and for preoperative nutritional status, the NRS-2002 score.
CR-POSSUM Calculator → NRS-2002 Score →Scientific references
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383. PubMed
Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245-1251. PubMed
Yang CC, Fong Y, Lin LC, et al. The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices. Applied to colorectal cancer: Medicine (Baltimore). 2015;94(41):e1743. PMC
Methodological note: we use the original 1987 weights (19 conditions) and the age adjustment in the bands <50 / 50–59 / 60–69 / 70–79 / 80+. The literature also contains an alternative convention for the age bands (≤40 / 41–50 / ...), which can give a one-point difference. The administrative ICD adaptations (Deyo, Quan, Glasheen 2019) use different weights and are not interchangeable with this calculator.