SESSION TITLE: COPD Diagnosis & Evaluation Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Dyspnea, the most common symptom in COPD patients, can be assessed subjectively by dyspnea scales (Borg and MRC-Medical Research Council) and with CAT, wich includes an item (4th item, CAT4) to evaluate the severity of dyspnea. The severity of airflow obstruction (decline in FEV1) does not always correlate with the perceived severity of the symptom. The aim was to establish a correlation between the severity of dyspnea assessed by MRC scale or by the CAT4 and FEV1 value and to analyze the influence of body mass index (BMI) and sex on these parameters.
METHODS: We retrospectively evaluated a group of 111 patients with COPD: 81 men with COPD II-IV and 30 women with stage II-III GOLD. The following parameters were analyzed: dyspnea score on MRC scale and on the 4th item of CAT questionnaire and FEV1, considering BMI and sex of the patients.
RESULTS: Male patients: a mean age of 64.82 ± 7.61 years, mean BMI 27.44 ± 4.85 kg/m2, MRC score (3.24 ± 0.75), CAT4 score (3.82 ± 0.99), mean FEV1 (54.68 ± 13.73% of predicted values). Female COPD patients: a mean age of 66.2 ± 7.78 years, BMI 29.35 ± 4.75 kg/m2, MRC score (2.76 ± 0.83), CAT4 score (3.8 ± 0.89) and mean values of FEV1 (63.4 ± 12.06% of predicted values). Correlation between subjective assessment scores of dyspnea (MRC, CAT4) and obstruction revealed a strong negative correlation between MRC score and FEV1 in both sexes (r = -0.756 in men, r = -0.711 in women; p <0.0001), a moderate negative correlation between CAT4 score and FEV1 (r = - 0.406; p <0.0001 in men, r =- 0.413; p <0.05 in women), and a positive statistically significant correlation between MRC score and CAT4 score (r = 0.45; p <0.0001 in men, r = 0.478; p <0.01 in women). BMI did not correlate with any of the tested parameters in men with COPD but in female patients BMI had a weak positive association with MRC score (r = 0.303; p = 0.05) and a moderate but statistically significant correlation with CAT4 score (r = 0.469; p <0.01).
CONCLUSIONS: Subjective assessment of dyspnea through clinical scales or questionnaires is strongly and negatively correlated with the severity of bronchial obstruction (FEV1), especially in male COPD patients, being more significant for MRC scale than for CAT4 item. BMI, may influence the subjective perception of dyspnea from CAT4 item, especially in female COPD patients.
CLINICAL IMPLICATIONS: MRC scale brings a more accurate assessment of the severity of dyspnea compared with the 4th item of the CAT questionnaire.
DISCLOSURE: The following authors have nothing to disclose: Doina-Clementina Cojocaru, Paraschiva Postolache
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