Assessment of COPD exacerbation severity with the COPD Assessment Test

January 27, 2012, American Thoracic Society

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: 'Walking distance' test an accurate indicator of disease severity in patients with COPD

Related Stories

'Walking distance' test an accurate indicator of disease severity in patients with COPD

May 16, 2011
The six-minute walking distance test (6MWD), a test that measures a patient's ability to tolerate exercise and physical activity, is an effective tool for understanding disease severity in patients with chronic obstructive ...

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

November 4, 2011
Vitamin D levels are not related to acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in patients with severe COPD, according to a large prospective cohort study involving 973 North American patients. ...

Computed tomography shows changes in lungs associated with COPD flare-ups

July 27, 2011
Using computed tomography (CT), researchers have identified two types of structural changes in the lungs of patients with chronic obstructive pulmonary disease (COPD) that are associated with frequent exacerbations, or episodes ...

Recommended for you

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

New study validates clotting risk factors in chronic kidney disease

January 17, 2018
In late 2017, researchers from Boston University School of Medicine (BUSM) discovered and published (Science Translational Medicine, (9) 417, Nov 2017) a potential treatment target to prevent chronic kidney disease (CKD) ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

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.