Development of Multidimensional Assessment in COPD (MAC) score for short-to-medium-term prognosis in elderly COPD patients at high-risk of acute exacerbation

<bold>Background:</bold> The performance of Cumulative Illness Rating Scale for Geriatrics (CIRS) in COPD-setting for evaluation of comorbidity burden is unknown. Study objectives were to demonstrate a better predictive performance of CIRS in COPD outcomes compared with the validated prognostic indices in the COPD-setting and to develop a new CIRS-based score (“Multidimensional Assessment in COPD") for both the evaluations of comorbidity burden and the COPD severity. <bold>Methods:</bold> We enrolled 120 participants (≥65 year) with COPD diagnosis and at high risk of AE-COPD. For the MAC score development, comorbidity was measured using the CIRS-Comorbidity Index, whereas respiratory variables were calculated according to CODEx thresholds. The primary outcome was a composite of moderate or severe AE-COPD within 52-weeks. The secondary outcomes were severe AE-COPD at 12-weeks and at 52-weeks since the enrollment; <bold>Results:</bold> CIRS and MAC score c-statistics are showed in figure 1. <fig><object-id>erj;64/suppl_68/PA2952/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> CIRS is a valuable tool for assessing comorbidities, showing superior predictive performance than other established prognostic indices. By combining CIRS with respiratory variables, MAC score significantly improves predictive performance on both short-to-medium-term COPD outcomes.