Kim Bo-Guen, Shin Sun Hye, Gil Hyun-Il, Zo Sungmin, Im Yunjoo, Song Ju Yeun, Lee Chai Young, Kang Danbee, Cho Juhee, Park Hye Yun
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Ther Adv Chronic Dis. 2022 Jul 30;13:20406223221114235. doi: 10.1177/20406223221114235. eCollection 2022.
The chronic obstructive pulmonary disease (COPD) assessment test (CAT) measures the health status of patients with COPD. We aimed to investigate the change in individual CAT scores after short-term bronchodilator therapy among treatment-naïve patients with COPD.
Data from 148 patients newly diagnosed with COPD between January 2016 and April 2020 were retrospectively analyzed. We compared the CAT score, modified Medical Research Council (mMRC) dyspnea grade, and forced expiratory volume in 1 s (FEV) before and after short-term (6 ± 2 months) bronchodilator therapy. We analyzed the change trends using generalized estimating equations.
The mean patient age was 70.9 years, and 92.6% were male. The total CAT score did not significantly improve. However, among the CAT items, phlegm [adjusted difference: -0.22 (-0.48, -0.002)], chest tightness [-0.30 (-0.56, -0.05)], and breathlessness [-0.45 (-0.66, -0.23)] scores significantly improved after bronchodilator therapy. The patients were divided into two groups: CAT score improved ( = 69) and not improved group ( = 79). The development of moderate-to-severe exacerbations during follow-up was significantly lower (2.9% 17.7%, = 0.004) in the CAT score improved group.
The improvement in CAT items indicating respiratory symptoms was more evident than the CAT total score after short-term bronchodilator therapy. Despite the significant increase in FEV after bronchodilator therapy, fewer than half of the patients achieved meaningful improvement in CAT, and this group showed significantly lower development of exacerbation during follow-up.
慢性阻塞性肺疾病（COPD）评估测试（CAT）用于衡量COPD患者的健康状况。我们旨在研究初治COPD患者短期支气管扩张剂治疗后个体CAT评分的变化。
回顾性分析2016年1月至2020年4月期间新诊断为COPD的148例患者的数据。我们比较了短期（6±2个月）支气管扩张剂治疗前后的CAT评分、改良医学研究委员会（mMRC）呼吸困难分级和第1秒用力呼气容积（FEV）。我们使用广义估计方程分析变化趋势。
患者平均年龄为70.9岁，92.6%为男性。CAT总分没有显著改善。然而，在CAT项目中，支气管扩张剂治疗后痰液[调整差异：-0.22（-0.48，-0.002）]、胸闷[-0.30（-0.56，-0.05）]和呼吸急促[-0.45（-0.66，-0.23）]评分显著改善。患者分为两组：CAT评分改善组（=69）和未改善组（=79）。CAT评分改善组随访期间中重度急性加重的发生率显著较低（2.9%对17.7%，=0.004）。
短期支气管扩张剂治疗后，表明呼吸道症状的CAT项目改善比CAT总分更明显。尽管支气管扩张剂治疗后FEV显著增加，但不到一半的患者在CAT方面取得了有意义的改善，且该组在随访期间急性加重的发生率显著较低。
