COPD Assessment Test Predicts Exacerbation Severity

The COPD Assessment Test (CAT) provides a reliable score of exacerbation severity in patients with chronic obstructive pulmonary disease (COPD), according to a study published online Jan. 26 in the American Journal of Respiratory and Critical Care Medicine.

Alex J. Mackay, of the University College London Medical School, and colleagues followed 161 patients enrolled in the London COPD cohort. The patients completed the CAT at baseline while in a stable state, at exacerbation, and during recovery. Frequent exacerbators were defined as two or more exacerbations per year.

The researchers found that frequent exacerbators had significantly higher baseline CAT scores than infrequent exacerbators (19.5 ± 6.6 versus 16.8 ± 8.0). In 152 exacerbations, CAT scores rose significantly, from an average baseline value of 19.4 ± 6.8 to 24.1 ± 7.3 at exacerbation. Change in CAT score from baseline to exacerbation onset was significantly but weakly related to change in serum C-reactive protein, but not to change in fibrinogen. At exacerbation, rises in CAT score were significantly related to falls in forced expiratory volume in one second. Median recovery time, as judged by symptom diary cards, was significantly associated with the time taken for the CAT score to return to baseline.

"The CAT provides a reliable score of exacerbation severity, and its incorporation into assessment strategies may aid health care professionals to determine the severity of exacerbations and potentially assist management," the authors write.

The study was funded by GlaxoSmithKline.

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