Comparing comorbidity scales: Attending physician score versus the Cumulative Illness Rating Scale for Geriatrics

Abstract

The CIRS-G scores and LI-scores had poor agreement, indicating that assessment method affects the registration of comorbidity. Thorough descriptions of comorbidity registrations in trials are paramount due to lack of a standardized assessment.

Cumulative Illness Rating Scale (CIRS) can be Used to Predict Hospital Outcomes in Older Adults

“…It has been validated as a predictor of long-term mortality when assessed in inpatient [3,5] and residential [4] settings. In a more recent study, however, it was found that non-medically trained raters and oncologists would have varying interpretations of comorbidity when assessing the same patient's medical records [6]. The Charlson Comorbidity Index (CCI) has been extensively studied and validated as a predictor of re-hospitalization [7], functional decline [8,9], and mortality in a number of populations [7][8][9][10][11][12][13].…”

Variables determining clinical complexity in hospitalized Internal Medicine patients: a workload analysis

“…Overall, mean CIRS-SI was 1.03 (SD=0.31) and median CIRS-CI was 2 (range 1-5) equivalent to a moderate comorbidity. The mean number of diagnoses at discharge was 5.9 (SD=2.3), the median number of clinical tests performed during hospitalization was 8 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], and the mean number of medications prescribed at discharge was 8 (SD=3.2).…”

“…12 To the best of our knowledge, an objective measure of patient's clinical complexity, considering all the characteristics and variables of a specific health care setting, is lacking. 17,18 The major weakness of the used methods is that the staff workload is conceptualized at a macro level, without taking into account the specific organizational characteristics (e.g., physical layout, information technology available) that may significantly affect workload. 19 When performing their tasks, clinicians and nurses encounter different situations and patients, which are determinants of the situation-and patientlevel workloads.…”

Assessment of comorbidity in lung cancer: How, why, and in whom?

“…There is often poor or weak correlation among scales. 5,11,12 It is likely that specific components of comorbid disease have an association with outcomes in advanced lung cancer rather than a composite score that may overstate the "weight" of some conditions and undervalue others. A recent report found that specific components of comorbidity, i.e., congestive heart failure and cerebrovascular disease demonstrated a negative association with overall survival but not the composite score as a single variable.…”

“…4 In the current issue of the Journal of Geriatric Oncology, Kirkhus et al report on two methods of measuring comorbidity in patients treated on a Norwegian multicenter phase III trial comparing two first-line chemotherapy regimens in advanced NSCLC. 5 This is a well-conducted secondary analysis comparing a validated tool (CIRS-G, Cumulative Illness Rating ScaleGeriatric) to a simpler tool devised by local investigators (LI) to assess comorbidity and its impact. Investigators found that more comorbidities and a higher severity were registered by the CIRS-G compared to the LI score.…”