Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Influence of Comorbidities on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: Risk Prediction of Acute Exacerbations Using the Cumulative Illness Rating Scale (Cirs)

Version 1 : Received: 6 November 2023 / Approved: 7 November 2023 / Online: 7 November 2023 (10:33:41 CET)

A peer-reviewed article of this Preprint also exists.

Di Raimondo, D.; Pirera, E.; Pintus, C.; De Rosa, R.; Profita, M.; Musiari, G.; Siscaro, G.; Tuttolomondo, A. The Role of the Cumulative Illness Rating Scale (CIRS) in Estimating the Impact of Comorbidities on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: A Pilot Study of the MACH (Multidimensional Approach for COPD and High Complexity) Study. J. Pers. Med. 2023, 13, 1674. Di Raimondo, D.; Pirera, E.; Pintus, C.; De Rosa, R.; Profita, M.; Musiari, G.; Siscaro, G.; Tuttolomondo, A. The Role of the Cumulative Illness Rating Scale (CIRS) in Estimating the Impact of Comorbidities on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: A Pilot Study of the MACH (Multidimensional Approach for COPD and High Complexity) Study. J. Pers. Med. 2023, 13, 1674.

Abstract

Background. Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous systemic syn-drome that often coexists with multiple comorbidities. In high-complex COPD patients the role of the Cumulative Illness Rating Scale (CIRS) as a risk predictor of COPD exacerbation is not known. Objective. To determine the effectiveness of the CIRS score in detecting the association of comorbidities and disease severity with the risk of acute exacerbations in COPD patients. Methods. 105 adults with COPD were included in this prospective study. All participants at baseline had at least 2 moderate exacerbations or 1 leading to hospitalization. The primary outcome was a composite of moderate or severe COPD exacerbation during 12-months follow-up. Results. CIRS indices (CIRS total score, Severity Index and Comorbidity Index) showed a positive correlation with mMRC, CAT and a negative correlation with FEV1, FVC, FEV1/FVC. The three CIRS indices were able to predict the 12-month rate of moderate or severe exacerbation (CIRS-Total Score: Hazard Ratio (HR) = 1.12 (95% CI: 1.08-1.21); CIRS-Severity Index: HR = 1.21 (95% CI: 1.12-1-31); CIRS-Comorbidity Index = 1.58 (95% CI: 1.33-1.89)). Conclusions. Among patients with COPD, comorbidity number and severity, assessed by the CIRS score, influence the risk in moderate to severe exacerbations. The CIRS score also correlates with the severity of respiratory symptoms and lung function

Keywords

Comorbidity; Multimorbidity; Chronic Obstructive Pulmonary Disease; COPD; Cumulative Illness Rating Scale; acute exacerbation of COPD (AECOPD)

Subject

Biology and Life Sciences, Aging

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