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

Osborn, Kilby P

doi:10.23937/2469-5858/1510030

Cited by 20 publications

(10 citation statements)

References 18 publications

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“…We used the CIRS to assess a patient’s level of disability and as an indicator of health status, including predicted 18-month mortality and social function [ 27 ]. The calculated CIRS on admission is useful for predicting important hospital outcomes such as high risk of death or long stays and to better anticipate end of life issues.…”

Section: Methodsmentioning

confidence: 99%

Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Spielmanns

Pekacka-Egli

Schoendorf³

et al. 2021

IJERPH

164

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Background: Severe COVID-19 infection often leads to impairments requiring pulmonary rehabilitation (PR) following the acute phase. Little is known about the efficacy of PR in these patients. We therefore compared post-COVID-19 patients (PG) referred to PR patients with other lung diseases (LG). Methods: 99 PG were admitted to PR. In a prospective design, the results of PG were collected and compared to the results of LG of 2019 (n = 419) according to Functional Independence Measurement (FIM), Cumulative Illness Rating Scale (CIRS), 6-minute walk test (6-MWT), duration of PR, and Feeling Thermometer (FT). Results: According to age, sex, and CIRS, both groups showed no significant differences. The improvements in the 6-MWT in the pre to post comparison were on average 180 (±101) meters for PG and 102 (±89) meters for LG (p < 0.001). FT showed a significant enhancement for PG of 21 (±14) points and for LG of 17 (±16) points (p < 0.039), while FIM significantly increased by 11 (±10) points in PG and 7 (±8) points in LG (p < 0.001). Conclusions: Comprehensive PR in PG is very effective according to the results in FIM, 6-MWT and FT. Therefore, we recommend PR following severe post-COVID-19 infections.

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Section: Methodsmentioning

confidence: 99%

Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Spielmanns

Pekacka-Egli

Schoendorf³

et al. 2021

IJERPH

164

View full text Add to dashboard Cite

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“…If there were different diseases within the same organ system, only the disease that was most pronounced was evaluated. The CIRS was used as a morbidity index in order to assess a patient's level of disability and as an indicator of health status, including predicted 18 month mortality and social function [23]. The calculated CIRS at admission is useful for predicting important hospital outcomes such as high risk of death or long stays and to better anticipate end-of-life issues.…”

Section: Cumulative Illness Rating Scale (Cirs)mentioning

confidence: 99%

Clinical and Functional Predictors of Response to a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

et al. 2021

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Background: Pulmonary rehabilitation (PR) following severe and very severe COVID-19 infection is known to be effective, according to typical assessments. However, not all patients benefit from PR to the same extent. This analysis aimed to identify the impact of different factors on PR outcomes in post-COVID-19 patients. Methods: This prospective observational study included 184 post-COVID-19 patients. The achievement of the predicted reference walking distance (6 min walking distance (6-MWD)) served as a parameter with which to identify responders and non-responders to PR. Several parameters (e.g., Functional Independent Measurement (FIM); pulmonary function testing (Forced Vital Capacity, FVC); 6MWD) were assessed in order to estimate their impact on PR success. Logistic regression models and classification and regression trees were used for multivariate analysis. Results: A total of 94 patients (51%) reached their reference 6MWD by the end of PR. FVC (0.95 (0.93–0.97)), 6MWD at admission (0.99 (0.99–1.00)), and FIM motoric (0.96 (0.93–0.99)) correlated with the risk not reaching the reference distance. The most important variable was the 6MWD at admission. Classification and regression tree identified 6MWD ≥ 130 m at admission and FVC predicted of >83% as the strongest predictor for reaching predicted 6-MWD. Conclusion: Post-COVID-19 patients with lower 6MWD, lower motoric FIM scores and lower FVC at admission have a high risk of not reaching their target values of physical performance despite intensive rehabilitation. As well as identifying them, it is of utmost importance to develop optimal PR concepts for these patients.

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“…14 The Cumulative Illness Rating Scale has been validated as a predictor for readmission for hospitalized older adults, hospitalization within 1 year in a residential setting, and long-term mortality when assessed in inpatient and residential settings. 15…”

Section: Comorbiditymentioning

confidence: 99%

Use of Comprehensive Geriatric Assessment in Oncology Patients to Guide Treatment Decisions and Predict Chemotherapy Toxicity

Tarchand¹

2021

Federal Practitioner

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Our objective was to review the utility of pretreatment comprehensive geriatric assessment (CGA) and its impact on decision making regarding choice and intensity of oncologic therapeutic regimens for older, frail, or poorfunctional-status patients, as well as using this prospective assessment to predict chemotherapy-related toxicities. Database searches were conducted in Medline, PubMed, and Ovid for clinical studies, review articles, and journal publications. Search terms included geriatric assessment, medical oncology, chemotherapy, frailty, toxicity, and functional status. Thirty-seven pertinent articles were retrieved and serve as the basis for this clinical review. Observations: CGA is an important tool for examining aspects of frailty and functional status that are not captured by traditional performance status measures. These findings may then be used in selection of appropriate therapeutic regimens for a given patient that are efficacious and tolerable. Such pretreatment assessments also have been used in predicting therapy-related toxicities. Conclusions: Frail and older patients are common in oncology practices and are at high risk for therapyrelated toxicities because of comorbidities and physiologic changes, presenting a considerable clinical challenge. CGA establishes evidence-based strategies to better assess the functional status of such patients and is predictive for chemotherapy-related toxicities in this vulnerable group. Despite publications on these measures in the oncology literature, there is limited evidence-based research to demonstrate the utility of CGA by practicing oncology providers and how to implement it into practice.

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

Abstract: Background/Objectives: Illness severity and comorbidity rating scales have been found to predict long-term outcomes for older hospitalized adults. This study was designed to determine if these rating systems could also predict short-term hospital outcomes.

Cited by 20 publications

References 18 publications

Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Clinical and Functional Predictors of Response to a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

Use of Comprehensive Geriatric Assessment in Oncology Patients to Guide Treatment Decisions and Predict Chemotherapy Toxicity

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