Summary:
INTRODUCTION:
The COPD Assessment Test (CAT) is an eight-item questionnaire suitable for
routine clinical use that reliably assesses the impact of COPD symptoms on
health status in stable and exacerbating COPD.
PURPOSE:
The aim of this study was to assess the usefulness of the CAT to detect changes
in health status in patients experiencing COPD exacerbations (ECOPD) and to
examine the correlations between CAT and disease outcome measures in a one year’
s follow up.
METHODS:
Sixty eight patients (84% males, mean age ± SD, 71 ± 6.7 years, mean BMI ± SD,
26.7 ± 5.8) hospitalized for an ECOPD completed the CAT at baseline (during the
first 48 hours of admission), and 3, 6, and 12 months after their discharge
from the hospital.
RESULTS:
Independent sample t-test showed a statistically significant difference between
the values of MRC scale during exacerbation and after 3 months (t=8,6, df=55,
p<0,001), at 6 months (t=8,21, df=52, p<0,001), and at 12 months (t=8,46,
df=45, p<0,001). The same thing happened between baseline CAT score and after 3
months (t=14,57, df=55, p<0,001), six months (t=13,33, df=52, p<0,001), and 12
months (t=13,7, df=45, p<0,001). Alongside, higher CAT scores during
exacerbation were proved in current smokers (t=-3,081, df=56, p=0,009).
Statistically significant were the connection between exacerbation CAT score
with re-introduction (t=-2,118, df=52, p=0,039), and the relationships between
CAT score 3 months later (t=2,586, df=53, p=0,013) and yearly (t=2,27, df=44,
p=0,028) with the existence of 2 or more exacerbations at baseline.
The FEV1 was associated with CAT and MRC. There was moderate negative
correlation between FEV1 and CAT in exacerbation (rho=-0,318, p=0,043) and 3
months later (rho=-0,321, p=0,049) and the exacerbational MRC (rho=-0,498,
p=0.001). A similar correlation with FEV1/FVC showed moderate negative
correlation with MRC at baseline (rho=-0,38, p=0,013).
BMI affect CAT scores where low weight compared to normal (36.6 ± 1.7 vs 29.8
±7.7, p <0.05 in AECOPD, 20 ± 7.2 vs 14.2 ± 8.8, p <0.05 at 3 months and 23.5 ±
2.1 vs 13.8 ± 7.8 , p <0.05 at 12 months).
CONCLUSION:
CAT scores increase at exacerbation, reflect the severity of the ECOPD as
determined by lung function, and predict the occurrence of at least one
exacerbation or hospitalization 3 months following discharge. Furthermore,
reflect the severity of COPD
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as determined by BMI, exacerbation rate and symptoms. The CAT showed to be
sensitive to the change in health status following ECOPD.
