# Charlson comorbidity index (Charlson) Charlson CCI Status: LIVE Price: $0.005 USDC `GET /api/calc/charlson` HTML: https://magentlab.com/docs/charlson Markdown: https://magentlab.com/docs/charlson.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the nineteen Charlson 1987 original comorbidity weights and return the published 1-year mortality group. ## When to use When an agent needs the Charlson 1987 original weighted index from caller-assigned flags and must not invent Deyo, Quan, ICD mapping, or age points. ## When not to use - Not a medical device and not a diagnosis. magent does not assign comorbidities from a chart or ICD codes. - This is the Charlson 1987 original weighted index only. It is not Deyo, not Quan, not ICD mapping, and not age-adjusted Charlson. - The nineteen flags are independent. Overlapping pairs (for example both diabetes flags) are summed as published weights, not silently dropped. - Age is not added. 1-year mortality groups follow Charlson 1987 (0 / 1–2 / 3–4 / ≥5) and are not a treatment order. - LACE takes a caller-supplied Charlson integer; this tool computes that integer from flags. ## Formula ``` CCI = myocardial_infarction 1 + congestive_heart_failure 1 + peripheral_vascular_disease 1 + cerebrovascular_disease 1 + dementia 1 + chronic_pulmonary_disease 1 + connective_tissue_disease 1 + peptic_ulcer_disease 1 + mild_liver_disease 1 + diabetes 1 + hemiplegia 2 + moderate_severe_renal_disease 2 + diabetes_end_organ 2 + any_tumor 2 + leukemia 2 + lymphoma 2 + moderate_severe_liver_disease 3 + metastatic_solid_tumor 6 + aids 6; Charlson 1987 original weighted index; max 37; 1-year mortality groups 0 / 1-2 / 3-4 / >=5; flags independent ``` ## Citation [A new method of classifying prognostic comorbidity in longitudinal studies: development and validation](https://doi.org/10.1016/0021-9681(87)90171-8) Charlson ME, Pompei P, Ales KL, MacKenzie CR J Chronic Dis. 1987;40(5):373-383 DOI: [10.1016/0021-9681(87)90171-8](https://doi.org/10.1016/0021-9681(87)90171-8) ## Worked example ### No comorbidities Given: `aids=false, any_tumor=false, cerebrovascular_disease=false, chronic_pulmonary_disease=false, congestive_heart_failure=false, connective_tissue_disease=false, dementia=false, diabetes=false, diabetes_end_organ=false, hemiplegia=false, leukemia=false, lymphoma=false, metastatic_solid_tumor=false, mild_liver_disease=false, moderate_severe_liver_disease=false, moderate_severe_renal_disease=false, myocardial_infarction=false, peptic_ulcer_disease=false, peripheral_vascular_disease=false` 1. All 19 flags false 2. score = 0 3. charlson_band = score_0 ### Metastatic solid tumor only Given: `aids=false, any_tumor=false, cerebrovascular_disease=false, chronic_pulmonary_disease=false, congestive_heart_failure=false, connective_tissue_disease=false, dementia=false, diabetes=false, diabetes_end_organ=false, hemiplegia=false, leukemia=false, lymphoma=false, metastatic_solid_tumor=true, mild_liver_disease=false, moderate_severe_liver_disease=false, moderate_severe_renal_disease=false, myocardial_infarction=false, peptic_ulcer_disease=false, peripheral_vascular_disease=false` 1. metastatic_solid_tumor → 6 2. score = 6 3. charlson_band = score_ge_5 ## Also searched as - Charlson comorbidity index - CCI - Charlson score - Charlson 1987 - Charlson weighted index - original Charlson index - comorbidity index Charlson ## Parameters - `myocardial_infarction` (boolean, required): Myocardial infarction as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose infarction. - `congestive_heart_failure` (boolean, required): Congestive heart failure as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose heart failure. - `peripheral_vascular_disease` (boolean, required): Peripheral vascular disease as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose vascular disease. - `cerebrovascular_disease` (boolean, required): Cerebrovascular disease as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose stroke or TIA. - `dementia` (boolean, required): Dementia as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose dementia. - `chronic_pulmonary_disease` (boolean, required): Chronic pulmonary disease as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose lung disease. - `connective_tissue_disease` (boolean, required): Connective tissue disease as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose connective-tissue disease. - `peptic_ulcer_disease` (boolean, required): Peptic ulcer disease as assigned by the caller (Charlson 1987). true scores 1. magent does not diagnose ulcer disease. - `mild_liver_disease` (boolean, required): Mild liver disease as assigned by the caller (Charlson 1987). true scores 1. magent does not grade liver disease. - `diabetes` (boolean, required): Diabetes without end-organ damage as assigned by the caller (Charlson 1987). true scores 1. Independent of diabetes_end_organ. magent does not diagnose diabetes. - `hemiplegia` (boolean, required): Hemiplegia as assigned by the caller (Charlson 1987). true scores 2. magent does not diagnose hemiplegia. - `moderate_severe_renal_disease` (boolean, required): Moderate or severe renal disease as assigned by the caller (Charlson 1987). true scores 2. magent does not grade kidney disease. - `diabetes_end_organ` (boolean, required): Diabetes with end-organ damage as assigned by the caller (Charlson 1987). true scores 2. Independent of diabetes. magent does not diagnose diabetes. - `any_tumor` (boolean, required): Any tumor (solid tumor without metastasis) as assigned by the caller (Charlson 1987). true scores 2. Independent of metastatic_solid_tumor. magent does not diagnose cancer. - `leukemia` (boolean, required): Leukemia as assigned by the caller (Charlson 1987). true scores 2. magent does not diagnose leukemia. - `lymphoma` (boolean, required): Lymphoma as assigned by the caller (Charlson 1987). true scores 2. magent does not diagnose lymphoma. - `moderate_severe_liver_disease` (boolean, required): Moderate or severe liver disease as assigned by the caller (Charlson 1987). true scores 3. Independent of mild_liver_disease. magent does not grade liver disease. - `metastatic_solid_tumor` (boolean, required): Metastatic solid tumor as assigned by the caller (Charlson 1987). true scores 6. Independent of any_tumor. magent does not diagnose cancer. - `aids` (boolean, required): AIDS as assigned by the caller (Charlson 1987). true scores 6. magent does not diagnose AIDS. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/charlson` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "aids": "false", "any_tumor": "false", "cerebrovascular_disease": "false", "chronic_pulmonary_disease": "false", "congestive_heart_failure": "false", "connective_tissue_disease": "false", "dementia": "false", "diabetes": "false", "diabetes_end_organ": "false", "hemiplegia": "false", "leukemia": "false", "lymphoma": "false", "metastatic_solid_tumor": "false", "mild_liver_disease": "false", "moderate_severe_liver_disease": "false", "moderate_severe_renal_disease": "false", "myocardial_infarction": "false", "peptic_ulcer_disease": "false", "peripheral_vascular_disease": "false" }, { "aids": "false", "any_tumor": "false", "cerebrovascular_disease": "false", "chronic_pulmonary_disease": "false", "congestive_heart_failure": "false", "connective_tissue_disease": "false", "dementia": "false", "diabetes": "false", "diabetes_end_organ": "false", "hemiplegia": "false", "leukemia": "false", "lymphoma": "false", "metastatic_solid_tumor": "false", "mild_liver_disease": "false", "moderate_severe_liver_disease": "false", "moderate_severe_renal_disease": "false", "myocardial_infarction": "false", "peptic_ulcer_disease": "false", "peripheral_vascular_disease": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/charlson Example 200: ```json { "count": 2, "path": "/api/calc/charlson", "items": [ { "components": [ { "factor": "myocardial_infarction", "points": 0, "present": false }, { "factor": "congestive_heart_failure", "points": 0, "present": false }, { "factor": "peripheral_vascular_disease", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "chronic_pulmonary_disease", "points": 0, "present": false }, { "factor": "connective_tissue_disease", "points": 0, "present": false }, { "factor": "peptic_ulcer_disease", "points": 0, "present": false }, { "factor": "mild_liver_disease", "points": 0, "present": false }, { "factor": "diabetes", "points": 0, "present": false }, { "factor": "hemiplegia", "points": 0, "present": false }, { "factor": "moderate_severe_renal_disease", "points": 0, "present": false }, { "factor": "diabetes_end_organ", "points": 0, "present": false }, { "factor": "any_tumor", "points": 0, "present": false }, { "factor": "leukemia", "points": 0, "present": false }, { "factor": "lymphoma", "points": 0, "present": false }, { "factor": "moderate_severe_liver_disease", "points": 0, "present": false }, { "factor": "metastatic_solid_tumor", "points": 0, "present": false }, { "factor": "aids", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Charlson ME, Pompei P, Ales KL, MacKenzie CR", "doi": "10.1016/0021-9681(87)90171-8", "id": "charlson-1987", "pmid": "3558716", "source": "J Chronic Dis. 1987;40(5):373-383", "title": "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" }, "formula": "charlson", "formula_expression": "CCI = myocardial_infarction 1 + congestive_heart_failure 1 + peripheral_vascular_disease 1 + cerebrovascular_disease 1 + dementia 1 + chronic_pulmonary_disease 1 + connective_tissue_disease 1 + peptic_ulcer_disease 1 + mild_liver_disease 1 + diabetes 1 + hemiplegia 2 + moderate_severe_renal_disease 2 + diabetes_end_organ 2 + any_tumor 2 + leukemia 2 + lymphoma 2 + moderate_severe_liver_disease 3 + metastatic_solid_tumor 6 + aids 6; Charlson 1987 original weighted index; max 37; 1-year mortality groups 0 / 1-2 / 3-4 / >=5; flags independent", "max_score": 37, "score": 0, "charlson_band": "score_0" }, { "components": [ { "factor": "myocardial_infarction", "points": 0, "present": false }, { "factor": "congestive_heart_failure", "points": 0, "present": false }, { "factor": "peripheral_vascular_disease", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "chronic_pulmonary_disease", "points": 0, "present": false }, { "factor": "connective_tissue_disease", "points": 0, "present": false }, { "factor": "peptic_ulcer_disease", "points": 0, "present": false }, { "factor": "mild_liver_disease", "points": 0, "present": false }, { "factor": "diabetes", "points": 0, "present": false }, { "factor": "hemiplegia", "points": 0, "present": false }, { "factor": "moderate_severe_renal_disease", "points": 0, "present": false }, { "factor": "diabetes_end_organ", "points": 0, "present": false }, { "factor": "any_tumor", "points": 0, "present": false }, { "factor": "leukemia", "points": 0, "present": false }, { "factor": "lymphoma", "points": 0, "present": false }, { "factor": "moderate_severe_liver_disease", "points": 0, "present": false }, { "factor": "metastatic_solid_tumor", "points": 0, "present": false }, { "factor": "aids", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Charlson ME, Pompei P, Ales KL, MacKenzie CR", "doi": "10.1016/0021-9681(87)90171-8", "id": "charlson-1987", "pmid": "3558716", "source": "J Chronic Dis. 1987;40(5):373-383", "title": "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" }, "formula": "charlson", "formula_expression": "CCI = myocardial_infarction 1 + congestive_heart_failure 1 + peripheral_vascular_disease 1 + cerebrovascular_disease 1 + dementia 1 + chronic_pulmonary_disease 1 + connective_tissue_disease 1 + peptic_ulcer_disease 1 + mild_liver_disease 1 + diabetes 1 + hemiplegia 2 + moderate_severe_renal_disease 2 + diabetes_end_organ 2 + any_tumor 2 + leukemia 2 + lymphoma 2 + moderate_severe_liver_disease 3 + metastatic_solid_tumor 6 + aids 6; Charlson 1987 original weighted index; max 37; 1-year mortality groups 0 / 1-2 / 3-4 / >=5; flags independent", "max_score": 37, "score": 0, "charlson_band": "score_0" } ] } ``` ## Response fields - `formula` (string): charlson - `formula_expression` (string): Exact expression used - `score` (integer): Charlson 1987 points 0-37 - `max_score` (integer): 37 - `charlson_band` (string): Charlson 1987 1-year mortality group: score_0 (0), score_1_2 (1-2), score_3_4 (3-4), or score_ge_5 (≥5). A group, not a diagnosis. - `components` (array): Per-flag points - `citation` (object): Charlson et al. J Chronic Dis 1987 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "myocardial_infarction", "points": 0, "present": false }, { "factor": "congestive_heart_failure", "points": 0, "present": false }, { "factor": "peripheral_vascular_disease", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "chronic_pulmonary_disease", "points": 0, "present": false }, { "factor": "connective_tissue_disease", "points": 0, "present": false }, { "factor": "peptic_ulcer_disease", "points": 0, "present": false }, { "factor": "mild_liver_disease", "points": 0, "present": false }, { "factor": "diabetes", "points": 0, "present": false }, { "factor": "hemiplegia", "points": 0, "present": false }, { "factor": "moderate_severe_renal_disease", "points": 0, "present": false }, { "factor": "diabetes_end_organ", "points": 0, "present": false }, { "factor": "any_tumor", "points": 0, "present": false }, { "factor": "leukemia", "points": 0, "present": false }, { "factor": "lymphoma", "points": 0, "present": false }, { "factor": "moderate_severe_liver_disease", "points": 0, "present": false }, { "factor": "metastatic_solid_tumor", "points": 0, "present": false }, { "factor": "aids", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Charlson ME, Pompei P, Ales KL, MacKenzie CR", "doi": "10.1016/0021-9681(87)90171-8", "id": "charlson-1987", "pmid": "3558716", "source": "J Chronic Dis. 1987;40(5):373-383", "title": "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" }, "formula": "charlson", "formula_expression": "CCI = myocardial_infarction 1 + congestive_heart_failure 1 + peripheral_vascular_disease 1 + cerebrovascular_disease 1 + dementia 1 + chronic_pulmonary_disease 1 + connective_tissue_disease 1 + peptic_ulcer_disease 1 + mild_liver_disease 1 + diabetes 1 + hemiplegia 2 + moderate_severe_renal_disease 2 + diabetes_end_organ 2 + any_tumor 2 + leukemia 2 + lymphoma 2 + moderate_severe_liver_disease 3 + metastatic_solid_tumor 6 + aids 6; Charlson 1987 original weighted index; max 37; 1-year mortality groups 0 / 1-2 / 3-4 / >=5; flags independent", "max_score": 37, "score": 0, "charlson_band": "score_0" } ``` ## Errors - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [LACE](https://magentlab.com/docs/lace) — Sum van Walraven 2010 Table 3 LACE points from length of stay, acute (emergent) admission, a caller-supplied Charlson integer, and ED visits in the previous 6 months. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.