Modified CCI

Q: All of the following are part of modified Charlson Comorbidity Index (CCI) EXCEPT? 

A) Heart failure 

B) Diabetes 

C) Renal insufficiency

D) Solid tumor 

E) Depression

Answer: E

Charlson comorbidity index (CCI) - modified - is mostly used in oncology patients to determine physiologic fitness, which is different from performance status. CCI is more oriented toward the severity of comorbid conditions. This helps in determining the treatment regimen for the patients. It divides patients into three categories 

• Medically fit: with CCI score of 0 to 2 
• Medically-unfit, but not frail: with CCI score of 3 
• Frail: Score above 3 

Comorbidities with single points are myocardial infarction (MI), heart failure, cerebrovascular disease, ulcer, mild hepatic disease, mild or moderate diabetes, moderate or severe pulmonary disease, and connective tissue disease. 

Severe diabetes with end-organ damage, moderate or severe renal disease, solid tumor without metastases carries 2 points each. 

Moderate to severe hepatic disease gets 3 points. Solid tumor with metastases gets the highest points - 6.

Depression is not included in CCI (choice E)

#oncology

Reference:

Etienne, A, Esterni, B, Charbonnier, A, et al. Comorbidity is an independent predictor of complete remission in elderly patients receiving induction chemotherapy for acute myeloid leukemia. Cancer 2007; 109:1376. Copyright © 2007 American Cancer Society.