Chronic obstructive pulmonary disease Assessment Test na avaliação de pacientes com doença pulmonar obstrutiva crônica em reabilitação pulmonar: há relação com nível de dispneia nas atividades de vida diária e com índice preditor de mortalidade? Estudo transversal

Abstract

O objetivo do estudo foi investigar se há relação entre o impacto da Doença Pulmonar Obstrutiva Crônica (DPOC) no estado de saúde com o nível de dispneia nas atividades de vida diária (AVD) e o índice preditor de mortalidade em pacientes em reabilitação pulmonar (RP). Trata-se de um estudo transversal, em que foram avaliados 32 pacientes com DPOC moderada a muito grave (23 homens; 66,6±12,0 anos; VEF1: 40,6±15,6% previsto) por meio do COPD Assessment Test (CAT), Índice de Massa Corpórea (IMC), Teste de Caminhada de Seis Minutos (TC6), London Chest Activity of Daily Living Scale (LCADL), modified Medical Research Council (mMRC) e Índice BODE (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity). Observaram-se correlações positivas moderadas do CAT com o questionário mMRC (r=0,35; p=0,048), a pontuação total da LCADL (r=0,60; p<0,001) e com a porcentagem da pontuação total da LCADL (r=0,57; p=0,001). Apenas a pontuação total da LCADL é capaz de predizer independentemente a pontuação do questionário CAT (p<0,05; r²=0,61). Não foram constatadas correlações significativas entre o CAT e o Índice BODE, IMC, TC6 e VEF1. Dessa forma, quanto maior o nível de dispneia nas AVD, maior o impacto da DPOC no estado de saúde do paciente, entretanto, o mesmo não ocorre em relação ao prognóstico de mortalidade nos pacientes com DPOC em RP.

Association between body mass index and patient-reported-outcome questionnaire scores (CAT™, ACT™, mMRC dyspnoea scale, IPAQ) in Ukraine, Kazakhstan and Azerbaijan: results of the CORE study

“…Mean CAT ™ total score in overweight/obese respondents in our study (from 4.2 to 5.9) was similar to that reported in the general health population as seen in the BREATHE study assessing the Arabic version (7.0) [26], the Japanese version of CAT ™ (5.8) [27], and the CAT ™ as assessed in Canada (6.0) [28]. Interestingly, in two cross-sectional studies assessing patients with stable COPD, the relationship between CAT ™ score and BMI was not statistically significant [29,30]. In Italy, also no significant correlation was found between the CAT ™ score and sex, age, BMI, or the educational level of subjects with COPD with different severities [31].…”

Validity of the Brazilian version of the COPD assessment test in patients with chronic obstructive pulmonary disease

“…Similarly, the mMRC scale also aims to quantify the functional limitation perceived by the patient due to his shortness of breath. A previous study from our laboratory 13 showed in their study with 32 subjects with a mean age of 66 years old diagnosed with COPD, with moderate to severe airflow obstruction, a significant positive correlation between CAT and mMRC ( r = 0.513; P < 0.001). This moderate positive correlation is reaffirmed by the correlation found in the present study, corroborating the idea that CAT is an instrument capable of reflecting the impact of respiratory function on the life of subjects with COPD, particularly that related to subjective shortness of breath.…”

“…COPD Assessment Test (CAT) —the questionnaire was used to assess the impact of COPD on the patient's quality of life and it was applied as an interview. It consists of eight items referring to the general symptoms and impact of COPD, scored according to their intensity and degree of limitation in ADLs 13 . For each of the symptoms (cough, phlegm, chest tightness and shortness of breath when climbing the ramp) and impact on quality of life (limitations on ADLs, confidence to leave the house, quality of sleep and energy), a score ranging from 0 to 5 in given, totalling 40 points maximum; the higher is the score, greater is the impact caused by COPD.…”