Course of COPD assessment test (CAT) and clinical COPD questionnaire (CCQ) scores during recovery from exacerbations of chronic obstructive pulmonary disease

Abstract

IntroductionCOPD exacerbations have a negative impact on lung function, decrease quality of life (QoL) and increase the risk of death. The objective of this study was to assess the course of health status after an outpatient or inpatient exacerbation in patients with COPD.MethodsThis is an epidemiological, prospective, multicentre study that was conducted in 79 hospitals and primary care centres in Spain. Four hundred seventy-six COPD patients completed COPD assessment test (CAT) and Clinical COPD Questionnaire (CCQ) questionnaires during the 24 hours after presenting at hospital or primary care centres with symptoms of an exacerbation, and also at weeks 4–6. The scores from the CAT and CCQ were evaluated and compared at baseline and after recovery from the exacerbation.ResultsA total of 164 outpatients (33.7%) and 322 inpatients (66.3%) were included in the study. The majority were men (88.2%), the mean age was 69.4 years (SD = 9.5) and the mean FEV1 (%) was 47.7% (17.4%). During the exacerbation, patients presented high scores in the CAT: [mean: 22.0 (SD = 7.0)] and the CCQ: [mean: 4.4 (SD = 1.2)]. After recovery there was a significant reduction in the scores of both questionnaires [CAT: mean: -9.9 (SD = 5.1) and CCQ: mean: -3.1 (SD = 1.1)]. Both questionnaires showed a strong correlation during and after the exacerbation and the best predictor of the magnitude of improvement in the scores was the severity of each score at onset.ConclusionsDue to their good correlation, CAT and CCQ can be useful tools to measure health status during an exacerbation and to evaluate recovery. However, new studies are necessary in order to identify which factors are influencing the course of the recovery of health status after a COPD exacerbation.

Utility of vest high frequency chest wall oscillation device versus flutter device in acute exacerbation of chronic obstructive pulmonary disease

“…Numerous studies come in agreement with our results and concluded that the reduction in CAT-score detects early health status improvement and chest wall vibration reduces dyspnea in COPD patients. 4,6,12,23 Our results also coincide with pilot study carried out by Chakravorty et al whom reported that patients with AECOPD and mucus hypersecretion are at increased risk of declining lung function, tolerated the HFCWO treatment well, leading to improvement in CAT-score and quality of life and reduced symptoms. 7 Moreover; our result is consistent with Mahajan et al, who stated that HFCWO is well tolerated in adults hospitalized for AECOPD or acute asthma and significantly improves dyspnea, also reported that patient with AECOPD use fewer antibiotics, due to fewer respiratory infections with less hospitalization.…”

“…The total CAT score was calculated by summing the points of each variable, the higher scores represent worse health. [8][9][10][11][12] It was classified into four categorizes; low (< 10), medium (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), high (21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and very high (> 30). (FEV1% pred = predicted amount as a percentage of the forced expiratory lung volume in one second; 6MWD = six minute walking distance; MMRC = modified medical research council dyspnea scale; BMI = body mass index.…”

“…CAT score can be a useful tool to measure health status during an exacerbation and evaluate recovery; also, CAT-score and the number of exacerbations will serve as a marker of disease control. 12 .…”

“…7 The chronic obstructive pulmonary disease assessment test (CAT) is designed for assessment of COPD impact on health status, it is simple questionnaires that cover daily symptoms; It include three parts (symptoms, activities and affection). [8][9][10][11][12] Identified items of CAT score include dyspnea, cough, expectoration and wheeze, also; systemic symptoms of fatigue and sleep disturbance. Additional indicators included limitations in daily activities, social life, emotional health and feeling in control with the use of rescue medication.…”

Upper Respiratory Symptoms Worsen over Time and Relate to Clinical Phenotype in Chronic Obstructive Pulmonary Disease

“…This is a validated eight-item questionnaire designed to assess and quantify the impact of COPD symptoms on patient health status 21 but it has been also shown to be a good tool in measuring severity 22 and recovery from exacerbations 23 . It also has two principal advantages in that it can be used in different clinical settings (primary care and second care) and shows no variability between languages 24 .…”