Observational studyAnnals of medicine2025
Comparison of the predictive performance of Cumulative Illness Rating Scale, Charlson Comorbidity Index and COMCOLD Index for moderate-to-severe exacerbations in elderly subjects with chronic obstructive pulmonary disease.
Observational study in Annals of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Development and Internal Validation of a Multivariable Prognostic Model for in-Hospital Mortality in Critically Ill Patients with Acute Exacerbation of COPD.International journal of chronic obstructive pulmonary disease · 2026Observational
- Pathogenesis, Diagnostic Advances, and Therapeutic Management of Chronic Obstructive Pulmonary Disease: A Narrative Review.International journal of chronic obstructive pulmonary disease · 2026Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveChronic Obstructive Pulmonary Disease (COPD) is frequently associated with multiple comorbidities that influence clinical outcomes. This study aimed to compare the predictive performance of the Cumulative Illness Rating Scale (CIRS) with the Charlson Comorbidity Index (CCI) and COMCOLD Index for moderate-to-severe COPD exacerbations. MATERIALS AND
methodsWe conducted a prospective observational study involving 200 COPD patients followed for 52 weeks. CIRS indices (Total Score, Severity Index, Comorbidity Index), CCI, and COMCOLD were calculated at baseline. The primary outcome was time-to-first moderate-to-severe exacerbation. Cox regression analyses and time-dependent receiver operating characteristic curves were used to assess prognostic performance at 12, 24, and 52 weeks.
resultsDuring follow-up, 66 patients (33%) experienced at least one moderate-to-severe exacerbation. All CIRS indices demonstrated significant correlations with respiratory parameters and symptom burden. In crude models, CIRS indices were significantly associated with exacerbation risk (CIRS-TS: HR 1.11, 95%CI 1.06-1.16; CIRS-SI: HR 1.16, 95%CI 1.09-1.23; CIRS-CI: HR 1.37, 95%CI 1.20-1.56; all
conclusionCIRS provides superior prognostic accuracy compared to established comorbidity indices in identifying COPD patients at increased risk of exacerbations. These findings highlight the clinical relevance of incorporating a comprehensive, severity-weighted comorbidity assessment in COPD management, supporting the concept of COPD as a complex, multisystem disorder requiring an integrated approach to care.
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