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COPD: sputum and exacerbations
P119 COPD assessment test scores: short-term changes during recovery from COPD exacerbation
  1. S Chandramouli,
  2. S Huq,
  3. J Lagan,
  4. L Davies
  1. University Hospital Aintree, Liverpool, UK

Abstract

Introduction The COPD assessment test (CAT) is a brief questionnaire that seems to serve as a reliable measure of COPD health status. (1). Little is known about CAT scores in patients in the UK hospitalised with COPD exacerbations and the impact of factors such as age, COPD severity and co-morbidities on CAT scores during recovery.

Aims To record CAT scores in patients hospitalised with COPD exacerbations. To assess the impact of age, FEV1 and co-morbidities on CAT score improvements.

Methods A random selection of patients presenting to our hospital between December 2009 and June 2010 with a clinical diagnosis of COPD exacerbation were approached. Those with radiological or clinical evidence of pneumonia, lung malignancy and bronchiectasis were excluded. All patients had evidence of fixed airflow obstruction on previous spirometry obtained from out-patient clinic visits and were current or ex smokers. Baseline demographics were recorded and patients were asked to complete CAT questionnaires on day 0 (day of hospital admission), day 2 and day 7.Questionnaires were completed at the bedside or, in those discharged, over the telephone. Charlson Comorbidity Indices (CCI) were calculated, using information from hospital case notes.

Results 83 patients (52 female) with a mean (SD) age of 67 (11) years and mean FEV1 of 43% (18) predicted were recruited. The median (range) CCI score was 4 (1–11). Mean (SD) CAT scores on days 0, 2 and 7 were 30.6 (5.8), 28.3 (6.7) and 26.4 (7.2) units respectively. The difference in scores between days 0 and 2 was −2.4 units (paired t-test, p<0.0001) and between days 0 and 7 was −4.2 units (p<0.0001). See Abstract P119 Table 1 for correlation co-efficients.

Conclusions Mean CAT scores in this group of hospitalised patients were very high in keeping with our previous studies in similar patients who had high St George's Respiratory Questionnaire scores. (2). CAT scores improve significantly as early as 2 days after treatment for an exacerbation and improve further by day 7. In our cohort, there was no significant correlation between improvement in CAT scores and age, FEV1 or CCI. Larger studies are needed to examine these relationships in more depth.

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