Universidad Central de Venezuela, Caracas, Venezuela.
Universidad de la República, Montevideo, Uruguay.
J Bras Pneumol. 2021 Nov 12;47(5):e20210156. doi: 10.36416/1806-3756/e20210156. eCollection 2021.
To assess the frequency and severity of 24-hour respiratory symptoms according to COPD GOLD-ABCD classification (2017-version), the distribution of the patients with COPD into GOLD categories using mMRC (≥2) or CAT (≥10) scores, and agreement between these cut-off points.
In this cross-sectional study (LASSYC study), 24-hour day respiratory symptoms were assessed by the Evaluating Respiratory Symptoms in COPD (E-RS) questionnaire, Nighttime Symptoms of COPD Instrument (NiSCI), Early Morning Symptoms of COPD Instrument (EMSCI), CAT and mMRC scores.
Among the 734 patients with COPD, 61% were male, age 69.6±8.7 years, FEV1% post-BD 49.1±17.5%, mMRC 1.8±1.0 and CAT 15.3±.8.1. By mMRC 33.7% were group-A, 29.2% group-B, 10.2% group-C and 26.9% group-D. By CAT 22.3% were group-A, 41% group-B, 4.8% group-C and 31.9% group-D. Using the mMRC the severity of E-RS, NiSCI and EMSCI scores increased from group A to D. Using the CAT, the groups B and D had the higher scores. Agreement between mMRC and CAT was 89.5% (Kappa statistics=75.7%). For mMRC score of 2, CAT score of ≥11 showed the maximum Youden's index (1.34). For mMRC score of 1, CAT score of ≥9 and ≥10 showed the maximum Youden's index (1.48).
GOLD COPD classification by CAT seems to better discriminate 24-hour symptoms. Results do not support the equivalent use of CAT≥10 and mMRC≥2 for assessing symptoms.
根据 COPD GOLD-ABCD 分类（2017 版）评估 24 小时呼吸症状的频率和严重程度，根据 mMRC（≥2）或 CAT（≥10）评分将 COPD 患者分配到 GOLD 类别，以及这些切点之间的一致性。
在这项横断面研究（LASSYC 研究）中，通过评估 COPD 中的呼吸症状（E-RS）问卷、夜间 COPD 工具（NiSCI）、清晨 COPD 工具（EMSCI）、CAT 和 mMRC 评分评估 24 小时日间呼吸症状。
在 734 名 COPD 患者中，61%为男性，年龄 69.6±8.7 岁，BD 后 FEV1%为 49.1±17.5%，mMRC 为 1.8±1.0，CAT 为 15.3±0.8。根据 mMRC，33.7%为 A 组，29.2%为 B 组，10.2%为 C 组，26.9%为 D 组。根据 CAT，22.3%为 A 组，41%为 B 组，4.8%为 C 组，31.9%为 D 组。使用 mMRC，E-RS、NiSCI 和 EMSCI 评分的严重程度从 A 组到 D 组逐渐增加。使用 CAT，B 组和 D 组的评分较高。mMRC 和 CAT 之间的一致性为 89.5%（Kappa 统计=75.7%）。对于 mMRC 评分 2，CAT 评分≥11 显示最大的 Youden 指数（1.34）。对于 mMRC 评分 1，CAT 评分≥9 和≥10 显示最大的 Youden 指数（1.48）。
CAT 评估的 COPD GOLD 分类似乎更好地鉴别 24 小时症状。结果不支持等效使用 CAT≥10 和 mMRC≥2 来评估症状。
