Assessment of COPD exacerbation severity with the COPD Assessment Test

January 27, 2012

Exacerbation severity in patients with chronic obstructive pulmonary disease (COPD) can be reliably assessed with the COPD Assessment Test (CAT), according to a new study from the UK.

"There is currently no widely accepted standardized method for assessing symptom severity at in COPD patients," said Dr Alex J Mackay, MBBS, MRCP, clinical research fellow at the Academic Unit of , University College London. "Incorporating CAT scores into the assessment of COPD patients may provide a standardized, objective method for assessing symptom severity in both clinical practice and clinical trials."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and .

The study involved 161 COPD patients who completed the eight-item CAT questionnaire at least once under supervision at the clinic. The CAT was also completed by 75 patients during 152 treated COPD exacerbations. The CAT is a validated health status questionnaire that has been successfully used in previous studies to measure COPD symptoms in both primary and secondary care settings. It includes questions assessing cough, phlegm, chest tightness, breathlessness, activity limitations, sleep, and energy levels.

Frequent exacerbators (≥2 exacerbations per year) had significantly higher baseline CAT scores than infrequent exacerbators. CAT scores in the 152 exacerbations assessed rose significantly from an average baseline value of 19.4±6.8 to a value of 24.1±7.3 at exacerbation. Change in CAT score from baseline to exacerbation onset was weakly but significantly related to change in CRP but not to change in fibrinogen. Rises in CAT score at exacerbation were significantly associated with falls in forced expiratory volume in one second (FEV1). Median recovery time, as determined using symptom diary cards, was significantly related to the time needed for CAT scores to return to baseline.

"In our patients with COPD, CAT scores reflected exacerbation severity, as measured by both exacerbation length and reduction in lung function," said Dr. Mackay. "CAT scores at exacerbation were also weakly related to systemic inflammatory markers and were elevated in stable patients with a history of frequent exacerbations. Our results indicate that the CAT can be used as a score of the multi-dimensional nature of COPD exacerbation severity."

"The CAT is validated, free, and easy to administer, and can be easily incorporated into the usual care of patients with COPD at no additional cost," concluded Dr. Mackay. "It may also be useful in clinical trials as an objective measure of new interventions aimed at reducing exacerbation severity. Since our results indicate that CAT scores may reflect levels of systemic inflammatory markers, albeit weakly, this finding may have particular relevance in clinical trials of anti-inflammatory therapeutic agents in COPD. "

Explore further: Low vitamin D levels do not increase the risk of chronic obstructive pulmonary disease

Related Stories

Recommended for you

Researchers discover rare flu-thwarting mutation

September 29, 2016

A rare and improbable mutation in a protein encoded by an influenza virus renders the virus defenseless against the body's immune system. This University of Rochester Medical Center discovery could provide a new strategy ...

Utah man may have contracted Zika from dying father's tears

September 29, 2016

A Utah man who mysteriously contracted Zika from his infected father may have got it by touching his dad's tears or sweat with his bare hands, according to new research unveiled Wednesday that found the unusual transmission ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.