A manual of guidelines to score the modified cumulative illness rating scale and its validation in acute hospitalized elderly patients.
OBJECTIVE
To update previous guidelines to score the Cumulative Illness Rating Scale (CIRS) and test their usefulness in hospitalized elderly patients.


METHODS
The CIRS was scored retrospectively in a cohort of elderly patients followed for 18 months.


METHODS
An acute internal medicine ward in an academic tertiary care hospital.


METHODS
Three hundred eighty-seven patients aged 65 and older.


METHODS
The CIRS was retrospectively scored for the enrolled patients. Intrarater and interrater reliability were calculated. Two illness severity indices (total score (TSC) and severity (SV)) and one comorbidity index (CM) were obtained. Clinical features and comprehensive geriatric assessment (CGA) variables were also used. All patients underwent an 18-month follow-up for mortality and rehospitalization.


RESULTS
Intrarater and interrater reliability of the CIRS scored following the guidelines was good (intraclass correlation coefficients of 0.83 and 0.81, respectively). The TSC, SV, and CM correlated with clinical features (laboratory values, medication usage, and length of in-hospital stay) and CGA variables (cognitive impairment, depression and disability). All three indices were able to predict 18-month mortality and rehospitalization rates.


CONCLUSIONS
This study confirmed the validity of the CIRS as an indicator of health status and demonstrated its ability to predict 18-month mortality and rehospitalization in hospitalized elderly patients. The availability of detailed guidelines for scoring the CIRS can improve its usefulness and facilitate more-widespread use for research and clinical aims.
Salvi
Fabio
F
Geriatric Rehabilitation Unit, Italian National Institute for Research and Care on Aging, Appignano, Italy. f.salvi@univpm.it
Miller
Mark D
MD
Grilli
Annalisa
A
Giorgi
Raffaella
R
Towers
Adele L
AL
Morichi
Valeria
V
Spazzafumo
Liana
L
Mancinelli
Lucia
L
Espinosa
Emma
E
Rappelli
Alessandro
A
Dessì-Fulgheri
Paolo
P
D000368:Aged; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D008297:Male; D009026:Mortality; D015588:Observer Variation; D010359:Patient Readmission; D011581:Psychological Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index