Course of COPD assessment test (CAT) and clinical COPD questionnaire (CCQ) scores during recovery from exacerbations of
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RESEARCH
Open Access
Course of COPD assessment test (CAT) and clinical COPD questionnaire (CCQ) scores during recovery from exacerbations of chronic obstructive pulmonary disease Marc Miravitlles1*, Patricia García-Sidro2, Alonso Fernández-Nistal3, María Jesús Buendía4, María José Espinosa de los Monteros5 and Jesús Molina6
Abstract Introduction: COPD 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. Methods: This 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. Results: A 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. Conclusions: Due 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. Keywords: COPD, Health status, CAT, CCQ, Exacerbations
Introduction Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death in industrialized countries. The mortality rate of this disease is increasing and it is likely to become the third leading cause of death worldwide in 2020 [1,2]. COPD is often aggravated by acute periods of increased symptoms called exacerbations. These are the
* Correspondence: [email protected] 1 Pneumology Department, Hospital Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERS), Barcelona, Spain Full list of author information is available at the end of the article
most common reason for doctor’s visits, emergency department visits, hospital admissions and deaths [3]. In addition, numerous studies have shown that exacerbations generate a large impact on health systems [3,4]. For example, they cause 10-12% of primary care visits, 1-2% of emergency room visits and 10% of hospit
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