Association of CAT scores with exacerbations and comorbidity in COPD patients in Greece attended primary care settings

Abstract

Introduction: Health status measurement with CAT has been proposed for COPD management in the updated GOLD guidelines. We aimed to investigate CAT score correlation with AECOPD and comorbidity in a Greek cohort of COPD patients

Methods: Data were selected from 544 COPD patients from Greece through a prospective cross-sectional study, attending primary health care units. Demographic data, previous treatment, lung function testing,exacerbations and co-morbidity were recorded. Chi-square test, bivariate Pearson r correlation and binary logistic regression were applied on data regarding the CAT score, FEV₁ (% pred.), FEV₁/FVC (%) and certain clinical parameters of the disease.

Results: CAT scores classification percentages showed: 38% mild CAT score, medium impact level 46%, severe score 15% and very severe score 1.0%. 56.9% of the patients with exacerbated disease had medium CAT score while the 19.6% of them a high impact score (p<0.001). A positive correlation was found between CAT scores and risk for exacerbation Odds (95%CI): 1.2 (1.0-3.0), p<0.001 for the group with moderate impact CAT score, 1.9, (1.4-3.1), p<0.001 for high impact and 2.1, (1.3-2.9), p<0.001 for very high impact. Patients with comorbidity presented a higher risk of developing high and very high impact of CAT score: Odds(95%CI): Stroke 2.4 (1.7-4.2), p <0.001, heart failure 1.5, (1.1-1.9), p<0.001, peripheral vascular disease 1.3 (1.0-1.8), p<0.001, ischemic heart disease 1.8, (1.3-3.0), p<0.001, osteoporosis 1.5(1.2-1.8), p=0.03 and depressive symptoms 1.3 (1.1-1.8), p=0.04.

Conclusions: The co-existence of other diseases with COPD increases the probability of presenting a worse health status.