Validation of a measure of physical illness burden at autopsy: the Cumulative Illness Rating Scale

J Am Geriatr Soc. 1993 Jan;41(1):38-41. doi: 10.1111/j.1532-5415.1993.tb05945.x.


Objective: To further validate an objective measure of physical illness burden, the Cumulative Illness Rating Scale (CIRS).

Design: Survey with correlation of CIRS ratings made from physician interviews and review of medical records with post-mortem ratings made independently at tissue autopsy.

Subjects: Victims of completed suicide investigated by both psychological and tissue autopsy (n = 72).

Results: CIRS ratings made by examination of tissue at autopsy were highly predictive of analogous ratings based on historical data, accounting for 75% of the variance in CIRS scores. Taking autopsy findings as the gold standard of objective health assessment, historical ratings tend to underestimate physical illness at high levels of tissue pathology and to overestimate burden at lower levels.

Conclusions: The CIRS score, when derived from all available sources of medical information, is a valid objective measure of physical illness burden and has broad applicability to research in geriatrics.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autopsy / standards*
  • Comorbidity*
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Interviews as Topic
  • Male
  • Medical Records / standards*
  • Middle Aged
  • New York / epidemiology
  • Physicians
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index*
  • Suicide / statistics & numerical data*