中东北欧地区 COPD 患者 CAT（COPD 评估测试）评分的决定因素：POPE 研究。
Determinants of CAT (COPD Assessment Test) scores in a population of patients with COPD in central and Eastern Europe: The POPE study.
机构信息
Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
Department of Pneumology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic.
出版信息
Respir Med. 2019 Apr;150:141-148. doi: 10.1016/j.rmed.2019.03.007. Epub 2019 Mar 21.
BACKGROUND
The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants.
METHODS
The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes. Here we report the analysis of CAT scores with the objective of identifying their determinants, evaluating symptom load and investigating the distribution of scores among the participating countries. Additionally, we investigated the discrepancies between the CAT and modified Medical Research Council (mMRC) scores when used to classify patients according to the GOLD strategy.
RESULTS
The study included 3452 patients (69.2% men, mean forced expiratory volume in 1 s (FEV1% predicted) 52.5%). The mean CAT score was 17.5 (SD = 7.8), ranging from 15.1 in Hungary to 21.2 in Bulgaria. Multiple linear regression analysis showed six variables significantly associated with CAT scores: depression, number of previous exacerbations, 6-min walking distance, FEV1(%), mMRC and country and explained 47.2% of the variance of CAT. According to either CAT or mMRC, up to 23.9% patients would be classified in different GOLD groups.
CONCLUSIONS
The CAT score may be predicted by factors related to COPD severity, depression and exercise capacity, with significant differences in the distribution of CAT scores in different countries. According to our results CAT >10 is not equivalent to mMRC >2 for assessing symptom burden.
TRIAL REGISTRATION
ClinicalTrials.gov, identifier NCT02119494.
背景
COPD 评估测试（CAT）已被提议用于帮助指导慢性阻塞性肺疾病（COPD）的治疗。了解不同 COPD 人群的评分分布及其决定因素非常重要。
方法
POPE 研究是一项针对 11 个中东欧国家 COPD 患者的国际、观察性、横断面研究，旨在描述 COPD 表型。在这里，我们报告了 CAT 评分的分析结果，目的是确定其决定因素，评估症状负荷，并调查参与国家的评分分布。此外，我们还研究了 CAT 评分和改良的医学研究委员会（mMRC）评分在根据 GOLD 策略对患者进行分类时的差异。
结果
该研究纳入了 3452 名患者（69.2%为男性，平均用力呼气量 1 秒预测值（FEV1%pred）为 52.5%）。平均 CAT 评分为 17.5（标准差 [SD] = 7.8），范围从匈牙利的 15.1 到保加利亚的 21.2。多元线性回归分析显示，6 个变量与 CAT 评分显著相关：抑郁、既往加重次数、6 分钟步行距离、FEV1%、mMRC 和国家，解释了 CAT 评分变异的 47.2%。根据 CAT 或 mMRC，多达 23.9%的患者可能被归类为不同的 GOLD 组。
结论
CAT 评分可由与 COPD 严重程度、抑郁和运动能力相关的因素预测，不同国家 CAT 评分的分布存在显著差异。根据我们的结果，CAT >10 与 mMRC >2 用于评估症状负担并不等效。
试验注册
ClinicalTrials.gov，标识符 NCT02119494。
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