cci_calculator.py•15.5 kB
"""
CCI (Charlson Comorbidity Index) Calculator
"""
from typing import Dict, Any
from medcalc import (
BaseCalculator,
CalculatorInfo,
Parameter,
ParameterType,
ValidationResult,
CalculationResult,
register_calculator
)
from medcalc.utils import round_number
@register_calculator("cci")
class CCICalculator(BaseCalculator):
"""Charlson合并症指数计算器实现"""
def get_info(self) -> CalculatorInfo:
return CalculatorInfo(
id=32,
name="Charlson Comorbidity Index (CCI)",
category="critical_care",
description="Charlson Comorbidity Index for predicting 10-year survival based on age and comorbidities",
parameters=[
Parameter(
name="age",
type=ParameterType.NUMERIC,
required=True,
min_value=0,
max_value=120,
description="Patient age in years"
),
Parameter(
name="mi",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Myocardial infarction history"
),
Parameter(
name="chf",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Congestive heart failure"
),
Parameter(
name="peripheral_vascular_disease",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Peripheral vascular disease"
),
Parameter(
name="cva",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Cerebrovascular accident"
),
Parameter(
name="tia",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Transient ischemic attack"
),
Parameter(
name="dementia",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Dementia"
),
Parameter(
name="copd",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Chronic obstructive pulmonary disease"
),
Parameter(
name="connective_tissue_disease",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Connective tissue disease"
),
Parameter(
name="peptic_ulcer_disease",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Peptic ulcer disease"
),
Parameter(
name="liver_disease",
type=ParameterType.CHOICE,
required=False,
choices=["none", "mild", "moderate_to_severe"],
default="none",
description="Liver disease severity (none, mild, moderate_to_severe)"
),
Parameter(
name="diabetes_mellitus",
type=ParameterType.CHOICE,
required=False,
choices=["none", "uncomplicated", "end_organ_damage"],
default="none",
description="Diabetes mellitus severity (none, uncomplicated, end_organ_damage)"
),
Parameter(
name="hemiplegia",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Hemiplegia"
),
Parameter(
name="moderate_to_severe_ckd",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Moderate to severe chronic kidney disease"
),
Parameter(
name="solid_tumor",
type=ParameterType.CHOICE,
required=False,
choices=["none", "localized", "metastatic"],
default="none",
description="Solid tumor status (none, localized, metastatic)"
),
Parameter(
name="leukemia",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Leukemia"
),
Parameter(
name="lymphoma",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="Lymphoma"
),
Parameter(
name="aids",
type=ParameterType.BOOLEAN,
required=False,
default=False,
description="AIDS"
)
]
)
def validate_parameters(self, parameters: Dict[str, Any]) -> ValidationResult:
"""验证参数"""
errors = []
# 获取参数定义
param_defs = {p.name: p for p in self.get_info().parameters}
# 检查必需参数
for param_name, param_def in param_defs.items():
if param_def.required and param_name not in parameters:
errors.append(f"Missing required parameter: {param_name}")
if errors:
return ValidationResult(is_valid=False, errors=errors)
# 验证年龄参数
if "age" in parameters:
age = parameters["age"]
if not isinstance(age, (int, float)):
errors.append("Age must be a number")
elif age < 0 or age > 120:
errors.append("Age must be between 0 and 120 years")
# 验证布尔参数
boolean_params = [
"mi", "chf", "peripheral_vascular_disease", "cva", "tia", "dementia",
"copd", "connective_tissue_disease", "peptic_ulcer_disease",
"hemiplegia", "moderate_to_severe_ckd", "leukemia", "lymphoma", "aids"
]
for param in boolean_params:
if param in parameters and not isinstance(parameters[param], bool):
errors.append(f"{param} must be a boolean value")
# 验证选择参数
choice_params = {
"liver_disease": ["none", "mild", "moderate_to_severe"],
"diabetes_mellitus": ["none", "uncomplicated", "end_organ_damage"],
"solid_tumor": ["none", "localized", "metastatic"]
}
for param, valid_choices in choice_params.items():
if param in parameters and parameters[param] not in valid_choices:
errors.append(f"{param} must be one of: {', '.join(valid_choices)}")
return ValidationResult(
is_valid=len(errors) == 0,
errors=errors
)
def calculate(self, parameters: Dict[str, Any]) -> CalculationResult:
"""计算CCI评分"""
# 直接从参数字典获取值
age = parameters.get("age")
mi = parameters.get("mi", False)
chf = parameters.get("chf", False)
peripheral_vascular_disease = parameters.get("peripheral_vascular_disease", False)
cva = parameters.get("cva", False)
tia = parameters.get("tia", False)
dementia = parameters.get("dementia", False)
copd = parameters.get("copd", False)
connective_tissue_disease = parameters.get("connective_tissue_disease", False)
peptic_ulcer_disease = parameters.get("peptic_ulcer_disease", False)
liver_disease = parameters.get("liver_disease", "none")
diabetes_mellitus = parameters.get("diabetes_mellitus", "none")
hemiplegia = parameters.get("hemiplegia", False)
moderate_to_severe_ckd = parameters.get("moderate_to_severe_ckd", False)
solid_tumor = parameters.get("solid_tumor", "none")
leukemia = parameters.get("leukemia", False)
lymphoma = parameters.get("lymphoma", False)
aids = parameters.get("aids", False)
score = 0
explanation_parts = []
# 1. 年龄评分
if age < 50:
age_points = 0
elif 50 <= age < 60:
age_points = 1
elif 60 <= age < 70:
age_points = 2
elif 70 <= age < 80:
age_points = 3
else: # >= 80
age_points = 4
score += age_points
explanation_parts.append(f"Age {age} years: +{age_points} points")
# 2. 心肌梗死史 (1分)
if mi:
score += 1
explanation_parts.append("Myocardial infarction: +1 point")
# 3. 充血性心力衰竭 (1分)
if chf:
score += 1
explanation_parts.append("Congestive heart failure: +1 point")
# 4. 外周血管疾病 (1分)
if peripheral_vascular_disease:
score += 1
explanation_parts.append("Peripheral vascular disease: +1 point")
# 5. 脑血管疾病 (CVA或TIA，1分)
if cva or tia:
score += 1
cerebrovascular_type = []
if cva:
cerebrovascular_type.append("CVA")
if tia:
cerebrovascular_type.append("TIA")
explanation_parts.append(f"Cerebrovascular disease ({'/'.join(cerebrovascular_type)}): +1 point")
# 6. 痴呆 (1分)
if dementia:
score += 1
explanation_parts.append("Dementia: +1 point")
# 7. 慢性阻塞性肺病 (1分)
if copd:
score += 1
explanation_parts.append("Chronic obstructive pulmonary disease: +1 point")
# 8. 结缔组织疾病 (1分)
if connective_tissue_disease:
score += 1
explanation_parts.append("Connective tissue disease: +1 point")
# 9. 消化性溃疡病 (1分)
if peptic_ulcer_disease:
score += 1
explanation_parts.append("Peptic ulcer disease: +1 point")
# 10. 肝病
if liver_disease == "mild":
score += 1
explanation_parts.append("Liver disease (mild): +1 point")
elif liver_disease == "moderate_to_severe":
score += 3
explanation_parts.append("Liver disease (moderate to severe): +3 points")
# 11. 糖尿病
if diabetes_mellitus == "uncomplicated":
score += 1
explanation_parts.append("Diabetes mellitus (uncomplicated): +1 point")
elif diabetes_mellitus == "end_organ_damage":
score += 2
explanation_parts.append("Diabetes mellitus (end-organ damage): +2 points")
# 12. 偏瘫 (2分)
if hemiplegia:
score += 2
explanation_parts.append("Hemiplegia: +2 points")
# 13. 中重度慢性肾病 (2分)
if moderate_to_severe_ckd:
score += 2
explanation_parts.append("Moderate to severe chronic kidney disease: +2 points")
# 14. 实体瘤
if solid_tumor == "localized":
score += 2
explanation_parts.append("Solid tumor (localized): +2 points")
elif solid_tumor == "metastatic":
score += 6
explanation_parts.append("Solid tumor (metastatic): +6 points")
# 15. 白血病 (2分)
if leukemia:
score += 2
explanation_parts.append("Leukemia: +2 points")
# 16. 淋巴瘤 (2分)
if lymphoma:
score += 2
explanation_parts.append("Lymphoma: +2 points")
# 17. AIDS (6分)
if aids:
score += 6
explanation_parts.append("AIDS: +6 points")
# 生成解释
explanation = "Charlson Comorbidity Index (CCI) calculation:\n\n"
explanation += "\n".join([f"• {part}" for part in explanation_parts])
explanation += f"\n\nTotal CCI Score: {score} points"
# 添加10年生存率预测
if score == 0:
ten_year_survival = "98%"
elif score == 1:
ten_year_survival = "96%"
elif score == 2:
ten_year_survival = "90%"
elif score == 3:
ten_year_survival = "77%"
elif score == 4:
ten_year_survival = "53%"
elif score == 5:
ten_year_survival = "21%"
else: # >= 6
ten_year_survival = "2%"
explanation += f"\n\nPredicted 10-year survival: {ten_year_survival}"
return CalculationResult(
value=score,
unit="points",
explanation=explanation,
metadata={
"age_points": age_points,
"ten_year_survival": ten_year_survival,
"comorbidity_breakdown": {
"cardiovascular": (
(1 if mi else 0) +
(1 if chf else 0) +
(1 if peripheral_vascular_disease else 0) +
(1 if cva or tia else 0)
),
"neurological": (
(1 if dementia else 0) +
(2 if hemiplegia else 0)
),
"pulmonary": (1 if copd else 0),
"gastrointestinal": (
(1 if peptic_ulcer_disease else 0) +
(1 if liver_disease == "mild" else 0) +
(3 if liver_disease == "moderate_to_severe" else 0)
),
"endocrine": (
(1 if diabetes_mellitus == "uncomplicated" else 0) +
(2 if diabetes_mellitus == "end_organ_damage" else 0)
),
"renal": (2 if moderate_to_severe_ckd else 0),
"malignancy": (
(2 if solid_tumor == "localized" else 0) +
(6 if solid_tumor == "metastatic" else 0) +
(2 if leukemia else 0) +
(2 if lymphoma else 0)
),
"immunological": (
(1 if connective_tissue_disease else 0) +
(6 if aids else 0)
)
}
}
)