Source: International Congress 2014 – COPD: points to ponder
Disease area: Airway diseases

Abstract

The CAT questionnaire has been used to evaluate the severity of exacerbations of COPD, but there is no information about its posible use as prognositc factors of exacerbations.We designed a multicenter, observational and prospective study to evaluate if a change in CAT scores <3 units between admission and discharge for an exacerbation may predict clinical relapse in the following 3 months. A total of 105 patients were included (15 women), mean FEV1 46%. At 3 months after discharge 4 patients had died, 18 were readmitted (17%) and 15 suffered a new ambulatory exacerbation (14.3%). Mean CAT at admission was 24.8 and mean improvement at discharge was 6.5 units, with 75% of patients improving ³3 units . At 3 months, 56% of those who improved less than 3 units had failed (readmission, exacerbation or death) compared with only 29% of those who improved ³3 units (p=0.029). The other predictors of failure were: FEV1 <45%, Hb <14mg/dl and pCO2 at admission >44. In multiple regression analysis only a CAT score difference <3 between admission and discharge remained as significant predictor of failure at 3 months with OR: 6.1 (IC95%: 1.6-23;p=0.008). CAT score at admission correlated with BMI (R=-0.2;p=0.044), MRC dyspnea score (R=0.36;p<0.001) and blood glucose (R=0.2;p=0.043). There were no correlation between change in CAT score during admission and lenght of stay. Patients with purulent sputum had a worse CAT score at admission (26.2 vs 23.3;p =0.040).A change in CAT score <3 units between admission and discharge is a marker of risk of clinical failure during the next 3 monthsWe acknowledge GSK for the logistical support to organize INEPOC meetings.

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M. Barrecheguren, C. Martínez, E. Naval, P. García-Sidro, M. Bonnin, J. L. García-Rivero, R. Malo de Molina, P. J. Marcos, J. M. Diez, A. Herrejon, J. A. Ros, S. Mayoralas, M. Valle, M. Miravitlles (Barcelona, Valencia, Villarreal, Girona, Cantabria, Madrid, A Coruña, Murcia, Spain). Change in the COPD assessment test (CAT) score as predictor of short-term evolution of patients admitted for an exacerbation of COPD. Eur Respir J 2014; 44: Suppl. 58, 3633

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