Cumulative Illness Rating Scale (CIRS)

Introduction

CIRS uses a 5-point ordinal scales (score 0-4) to estimate the severity of pathology in each of 13 systems, including:

• cardiac
• respiratory
• renal
• musculoskeletal
• psychiatric

Based on the ratings, two scores are derived

• the Total Cumulative Illness Rating score (TCIRS)
  • reflects the overall burden of illness
  • based on the sum of the ratings across all 13 categories
  • range 0-52
• the Co-morbidity Index (CMI) score
  • reflects diversity of illnesses
  • total number of categories in which moderate or severe levels of pathology are noted
  • range 0-13

Higher scores in both TCIRS & CMI indicate greater medical complexity

The instrument has shown adequate test-retest reliability, construct & discriminative validity.

Very complex patients are those having a CMI >= 5

More general terms

• numerical rating scale (NRS)