How to Utilize CAT and mMRC Scores to Assess Symptom Status of Patients with COPD in Clinical Practice?

Yazar, Esra; Niksarlıoğlu, Elif Yelda; Yiğitbaş, Burcu Arpınar; Bayraktaroglu, Mesut

doi:10.4274/mmj.galenos.2022.06787

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Previous studies have shown a significant negative correlation between FFMI and mMRC scores and CAT scores, which was also verified in this study: reduced FFM and FFMI in patients in the more severe group compared with those with the less severe group, and FFM and FFMI were negatively correlated with mMRC scores and CAT scores. An explanation may be that the reduction of FFMI in patients with COPD will further deteriorate the lung function ( 32 ), and at the same time, the impaired lung function will also cause varying degrees of damage to the cellular structure of the respiratory muscles, leading to the aggravation of patients’ hypoxia, the disruption of muscle metabolism, the further reduction of FFMI ( 33 ), and the aggravation of clinical symptoms, which will lead to the formation of a vicious circle, and therefore, cause a great impact on the exercise capacity of patients with chronic obstructive pulmonary disease ( 34 ). Acute exacerbations of COPD are a major cause of accelerated disease progression and lead to early death.…”

Section: Discussionmentioning

confidence: 99%

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Jin,

Yang,

Chen

et al. 2024

Front. Med.

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BackgroundBody composition changes are important extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate the characteristics of body composition in patients with COPD, and its correlation with disease severity.MethodsA total of 105 COPD patients admitted to Zhongshan Hospital affiliated to Dalian University, from May 1, 2021 to January 31, 2023, were included as the COPD group, and 105 subjects without COPD were enrolled as the control group during the same period. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) comprehensive assessment indicators, COPD patients were divided into groups: the degree of pulmonary function airflow limitation was grouped according to FEV1%pred; clinical symptoms were grouped according to mMRC scores and CAT scores; the risk of acute exacerbation was divided into low risk and high risk groups. Body composition was measured by bioelectrical impedance analysis (BIA).Results(1) Concerning body composition, the body mass index (BMI), fat-free mass index (FFMI), and angle of phase (PhA) of COPD patients were lower than those of the control group. Extracellular water-to-total body water ratio (ECW/TBW) and extra-to-intracellular water ratio (ECW/ICW) were higher than those of the control group, and the difference was statistically significant (p < 0.05). (2) There were differences in body composition among COPD patients with different severity of disease: FFMI and PhA in the mild/moderate airflow limitation group were higher than those in the severe/very severe airflow limitation group. According to mMRC scores classification, the FFMI and PhA of the less symptomatic group were higher than those of the more symptomatic group, and ECW/TBW and ECW/ICW were lower than those of the more symptomatic group. According to CAT scores classification, FFMI and PhA in the mild/moderate disease group were higher than those in the severe/very severe disease group. The FFMI of the low-risk group was higher than that of the high-risk group, and ECW/TBW was lower than that of the high risk group. (3) Correlation analysis between body composition and disease severity indicators showed that FFMI and PhA were negatively correlated with mMRC scores and CAT scores, and positively correlated with FEV1%pred. ECW/TBW ratio and ECW/ICW ratio were positively correlated with mMRC scores and CAT scores, and negatively correlated with FEV1%pred, and the difference was statistically significant (p < 0.05).ConclusionThere are significant differences in body composition between COPD patients and the control group, and there are significant differences in body composition between COPD patients with different severity of disease, with correlations between body composition and severity of disease.

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Section: Discussionmentioning

confidence: 99%

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Jin,

Yang,

Chen

et al. 2024

Front. Med.

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“…This unidimensional estimation of dyspnoea could cause underestimation and limit the interpretation of our study. However, several studies have described mMRC-defined dyspnoea to be a predictive factor for disability and mortality 9 , 40 . Therefore, we consider that our study is still of great importance for identifying subjects who may require medical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we consider that our study is still of great importance for identifying subjects who may require medical intervention. Additionally, considering that those with an mMRC grade of 1 can be highly symptomatic 40 , 41 , we used a grade of 1 instead of 2 for the cut-off of the mMRC grade. This minimized underestimation and was suitable for our purpose of promoting early identification of subjects at risk.…”

Section: Discussionmentioning

confidence: 99%

Development of airflow limitation, dyspnoea, and both in the general population: the Nagahama study

Kogo

Sato

Muro

et al. 2022

Sci Rep

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Subjects with subclinical respiratory dysfunction who do not meet the chronic obstructive pulmonary disease (COPD) criteria have attracted attention with regard to early COPD intervention. Our aim was to longitudinally investigate the risks for the development of airflow limitation (AFL) and dyspnoea, the main characteristics of COPD, in a large-scale community-based general population study. The Nagahama study included 9789 inhabitants, and a follow-up evaluation was conducted after 5 years. AFL was diagnosed using a fixed ratio (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) < 0.7). We enrolled normal subjects aged 40–75 years with no AFL, dyspnoea or prior diagnosis of asthma or COPD at baseline. In total, 5865 subjects were analysed, 310 subjects had subclinical respiratory dysfunction (FEV1/FVC < the lower limit of normal; n = 57, and FEV1 < 80% of the predicted value (preserved ratio impaired spirometry); n = 256). A total of 5086 subjects attended the follow-up assessment, and 449 and 1021 subjects developed AFL and dyspnoea, respectively. Of these, 100 subjects developed AFL with dyspnoea. Baseline subclinical respiratory dysfunction was independently and significantly associated with AFL with dyspnoea development within 5 years. Subjects with subclinical respiratory dysfunction are at risk of developing COPD-like features and require careful monitoring.

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“…Dyspnea scales: The modified British Medical Research Council (mMRC) scale was used to assign dyspnea scores ranging from 0 to 4 to individuals [7].…”

Section: Methodsmentioning

confidence: 99%

Association Between Sarcopenia and Chronic Renal Failure (Overt and Concealed) in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Cross-Sectional Study

Dave,

Patel

et al. 2023

Cureus

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BackgroundSarcopenia, a syndrome characterized by a progressive decline in skeletal muscle mass, strength, and function, is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD). Chronic kidney disease (CKD) is a prevalent condition among patients with sarcopenia. Reports suggest that between 15% and 55% of stable COPD patients have sarcopenia. Therefore, the present study aims to determine the association between sarcopenia and chronic renal failure (overt and concealed) in COPD patients. MethodologyThis institutional-based cross-sectional study was conducted on patients diagnosed with COPD. Hospitalized adult COPD patients who gave consent were included. Sociodemographic information such as age, gender, residence, and prolonged length of stay in the hospital (categorized by a median of 10 days, considering its data distribution in our sample) was obtained using electronic medical records. Skeletal muscle %, visceral fat %, and body fat % were calculated using a bio-electrical impedance analysis device (Omron Body Composition Monitor, Model HBF-702T). Additionally, the strength of the hand grip was measured using a hand dynamometer. Sarcopenia was assessed following the criteria set by the Asian Working Group on Sarcopenia (AWGS). Chronic renal failure (CRF) was assessed by calculating the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) Study Group equation. Quantitative data were compared using an independent sample t-test. The association was determined using chi-square and multivariate logistic regression analyses. A p-value of <0.05 was considered significant. ResultsThe study found that the proportion of sarcopenia in COPD patients was 52%, with overt and concealed CRF prevalence rates of 31.5% and 27%, respectively. Sarcopenic individuals had significantly lower FEV1 and FEV1/FVC compared to non-sarcopenic patients. The incidence of sarcopenia significantly increased with rising BODE index (body mass index (BMI, B), airflow obstruction (O) as measured by the postbronchodilator FEV 1 (percentage of predicted value), dyspnea (D) assessed by the modified Medical Research Council (MMRC) score, and exercise tolerance (E) measured by 6-minute walking distance) and mMRC (modified Medical Research Council dyspnea scale) dyspnea scale scores. Both concealed CRF and overt CRF patients had four times higher odds of having sarcopenia (AOR=4). ConclusionThe study reveals a high prevalence of sarcopenia and provides evidence for the association between sarcopenia and chronic renal failure in COPD patients. These findings underscore the importance of early detection and management of sarcopenia and CRF in COPD patients to optimize their clinical outcomes.

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How to Utilize CAT and mMRC Scores to Assess Symptom Status of Patients with COPD in Clinical Practice?

Cited by 10 publications

References 27 publications

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Development of airflow limitation, dyspnoea, and both in the general population: the Nagahama study

Association Between Sarcopenia and Chronic Renal Failure (Overt and Concealed) in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Cross-Sectional Study

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