Clinical Role of the Chronic Obstructive Pulmonary Disease Assessment Test in Prediction of the Response to Treatment for Exacerbations

Usefulness of COPD Assessment Test as valuable predictor of depression in chronic obstructive pulmonary disease / 동물의과학연구지

Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, including depression, which carries a higher risk of exacerbation and hospitalization in patients with stable COPD. A newly developed questionnaire, the COPD Assessment Test (CAT), was developed as an alternative to other complex, time-consuming tools for quantifying the symptom burden of COPD in routine practice. It is possible that the correlation between the CAT and depression scales could be useful for early evaluation and management of depression in COPD patients. Thus, we investigated the relationship between the CAT and depression as measured by the Patient Health Questionnaires-9 (PHQ- 9). We performed a retrospective observational COPD cohort study. A total of 97 patients were enrolled. The Korean versions of the CAT and PHQ-9 were completed for stable patients. A correlation analysis was performed between the PHQ-9 and CAT scores. Significant depression among the groups based on the 2011 GOLD guidelines occurred only in class Gold B and D patients (40% and 60%, respectively). The frequency of depression was significantly higher in the group with higher CAT scores (20~29 versus > or =30; odds ratio: 5.67 versus 22.66). Significant association was observed between the PHQ-9 and CAT scores (r=0.545 and P<0.001). As a result, the PHQ-9 score was significantly higher in COPD patients with a higher CAT score. The CAT is a simple and valuable predictor of depression in COPD patients, and it should be frequently used to detect COPD patients with depression in clinical practice.

Value of CAT and mMRC in clinical evaluation of chronic obstructive pulmonary disease / 重庆医学

Objective To evaluate the health status ,dyspnea and exercise endurance in the patients with chronic obstructive pul-monary disease(COPD) by the CAT scale ,modified medical research council(mMRC) dyspnea scale and 6-min walk test(6MWT) and to analyze the correlation between their evaluation results with the percentage (FEV1% pred) of the forced expiratory volume at 1 second(FEV1) in the predict value and whether complicating pulmonary hypertension (PH) .Methods 70 patients with COPD were performed the examinations of the lung function ,CAT scale ,mMRC score and 6MWT .The correlation among the various e-valuation systems and between each evaluation system with the severity of the pulmonary function airway limitation were compre -hensively evaluated .The CAT scores ,mMRC scores and 6 min walking distance(6MWD) were compared between the COPD com-plicating PH group and the simple COPD group .Results The CAT scale was negatively correlated with 6MWD(r= -0 .623 ,P0 .05) .The CAT scores had statistical difference between the COPD complicating PH group and the simple COPD group (P<0 .01) .6MWD had the highest accuracy for screening COPD whether complicating PH ,followed by CAT .The diagnostic cut-off point by adopting CAT for judging the risk of COPD complicating PH was 21 .Conclusion The CAT scale has good correlation with 6MWD and no correlation with FEV1% pred .The CAT scale is more suitable for the overall assessment of the total severity of COPD .Patients with the high CAT scores have higher risk of suffering from PH .

Relationship between chronic obstructive pulmonary disease (COPD) assessment test score and prognostic factors of COPD patients / 第二军医大学学报

Objective To observe the correlation between chronic obstructive pulmonary disease (COPD) assessment test (CAT) score and prognostic factors, so as to investigate the value of CAT score in predicting the prognosis of COPD. Methods A total of 81 patients with newly diagnosed COPD in our hospital during Jul. 2011 to Sep. 2012, without using inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) or long-acting antimuscarinic agent (LAMA), were divided into group A (low risk, less symptoms), B (low risk, more symptoms), C (high risk, less symptoms) and D (high risk, more symptoms) groups according to Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2011 edition), and the patients were given ICS/LABA or ICS/LABA+ LAMA treatment for 3 months. The CAT score, age, smoking quantity, pulmonary function indices, body mass index (BMI), 6-min walking distance (6MWD), modified medical British research council (mMRC) dyspnea scale, and the times of acute exacerbation of COPD (AECOPD) in previous one year were collected before and after treatment. The clinical characteristics analysis and correlation analysis were performed. Results The average age of the 81 COPD patients was (66.27±8.52) years, with 88.89% being males and 85.19% having smoking history. The proportions of group A, B, C and D were 8.64%, 30.86%, 4.94% and 55.56% before treatment, repectively. The values of the forced expiratory volumein one second (FEV1), predicted amount as a percentage of FEV1 (FEV1%Pred), forced vital capacity (FVC), predicted amount as a percentage of FVC (FVC% Pred), peak expiratory flow (PEF), predicted amount as a percentage of PEF (PEF%Pred), and 6MWD in CAT score ≥ 10 groups were significantly less than those in CAT score 10 group (P < 0. 05). The above parameterswere not significantly different between patients with CAT score being 10-20, 20-30 and ≥ 30 groups. mMRC scale and times of AECOPD in CAT score ≥20 groups were significantly higher than those in CAT score 10 group (P < 0. 05). No significant difference in FEV1/FVC was found in different CAT score groups. The CAT score was significantly correlated with mMRC scale (pre-treatment r2 = 0. 417, P lt; 0. 001; post-treatment r2 =0. 19, P < 0. 001), 6MWD (pretreatment r2 = 0. 320, P < 0. 001 post-treatment r2 = 0. 19, P < 0. 001), pre-treatment FEV1 (r2 = 0. 177, P = 0. 001 5), FEV1 %Pred(r2 = 0. 125, P = 0. 002), PEF(r2=0. 164, P = 0. 002 4), PEF%Pred (r2=0. 129, P = 0. 007 6), FVC (r2 = 0. 098, P=0. 021), FVC%Pred (r2 = 0. 094, P = 0. 024), FEV1/FVC(r2 = 0. 101, P = 0. 005 7), and AECOPD number (r2 = 0. 059, P = 0. 028); and not correlated with the quantity of smoking (r2 = 0. 041, P = 0. 083), BMI (r2 =0. 00, P = 0.89), and post-treatment FEV1 (r2 =0. 01, P = 0. 22) or FEV1 %Pred (r2 =0. 003, P = 0. 09). Conclusion COPD is prone to occur in the male smokers, with the highest proportion found in group D. CAT score has a good correlation with pre- and pos-- treatment mMRC scale and exercise capacity, suggesting it has a potential for predicting prognosis of COPD.