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如何在临床实践中利用CAT和mMRC评分评估慢性阻塞性肺疾病患者的症状状态?

How to Utilize CAT and mMRC Scores to Assess Symptom Status of Patients with COPD in Clinical Practice?

作者信息

Ertan Yazar Esra, Niksarlioglu Elif Yelda, Yigitbas Burcu, Bayraktaroglu Mesut

机构信息

Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey.

University of Health Sciences Turkey, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Clinic of Chest Diseases, Istanbul, Turkey.

出版信息

Medeni Med J. 2022 Jun 23;37(2):173-179. doi: 10.4274/MMJ.galenos.2022.06787.

Abstract

OBJECTIVE

In this study, we aimed to investigate the compatibility of modified Medical Research Council (mMRC) and COPD assessment test (CAT) scores of chronic obstructive pulmonary disease (COPD) patients in terms of evaluation of their symptom status.

METHODS

The study was planned as a single-center, cross-sectional study. Statistically four separate receiver operating characteristic (ROC) curves of CAT scoring were generated for mMRC scores of 1 to 4.

RESULTS

Two hundred twenty eight patients with stable COPD, mean age 64.2±8.2 and 88.6% male were included. A strong positive correlation was detected between CAT and mMRC (r=0.60, p<0.001). However, it was observed that 32 patients had mMRC<2 but CAT≥10, while 21 patients had CAT<10 but mMRC≥2. Thus, in 53 patients CAT and mMRC scores were not identical in terms of assessed symptom status. According to the ROC analysis, the mMRC scores of 1 to 4 were most compatible with the CAT scores of 10, 10, 15, and 20, respectively.

CONCLUSIONS

Expanding current data represents that CAT score of 10 could be more compatible with mMRC score of 1. Moreover we think although a high mMRC or CAT score may be sufficient to assign patients to high symptom groups, it is needed to evaluate mMRC and CAT together to assign a patient to a low symptom group. In this way misclassification of the patients with high symptoms due to insufficient symptom evaluation as if they have low symptoms can be prevented.

摘要

目的

在本研究中,我们旨在探讨慢性阻塞性肺疾病(COPD)患者改良医学研究委员会(mMRC)评分与慢性阻塞性肺疾病评估测试(CAT)评分在评估其症状状态方面的兼容性。

方法

本研究设计为单中心横断面研究。针对mMRC评分为1至4的情况,统计生成了四条独立的CAT评分受试者工作特征(ROC)曲线。

结果

纳入了228例稳定期COPD患者,平均年龄64.2±8.2岁,男性占88.6%。检测到CAT与mMRC之间存在强正相关(r=0.60,p<0.001)。然而,观察到32例患者mMRC<2但CAT≥10,而21例患者CAT<10但mMRC≥2。因此,在53例患者中,CAT和mMRC评分在评估的症状状态方面并不一致。根据ROC分析,mMRC评分为1至4分别与CAT评分10、1日、15和20最兼容。

结论

现有数据进一步表明,CAT评分为10可能与mMRC评分为1更兼容。此外,我们认为,虽然高mMRC或CAT评分可能足以将患者归为高症状组,但要将患者归为低症状组则需要同时评估mMRC和CAT。这样可以防止因症状评估不足而将高症状患者误分类为低症状患者的情况发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fe9/9234363/2dcbf7799e5f/medj-37-173-g1.jpg

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