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Title: The chronic obstructive pulmonary disease assessment test improves the predictive value of previous exacerbations for poor outcomes in COPD
Author: Miravitlles Fernández, Marc
García-Sidro, Patricia
Fernández-Nistal, Alonso
Buendía, María Jesús
Espinosa de Los Monteros, María José
Esquinas López, Cristina
Molina, Jesús
Keywords: Malalties pulmonars obstructives cròniques
Medicina preventiva
Anàlisi multivariable
Assaigs clínics
Chronic obstructive pulmonary diseases
Preventive medicine
Multivariate analysis
Clinical trials
Issue Date: Nov-2015
Publisher: Dove Medical Press
Abstract: Introduction: Chronic obstructive pulmonary disease (COPD) exacerbations have a negative impact on the quality of life of patients and the evolution of the disease. We have investigated the prognostic value of several health-related quality of life questionnaires to predict the appearance of a composite event (new ambulatory or emergency exacerbation, hospitalization, or death) over a 1-year follow-up. Methods: This was a multicenter, prospective, observational study. Patients completed four questionnaires after recovering from an exacerbation (COPD Assessment Test [CAT], a Clinical COPD Questionnaire [CCQ], COPD Severity Score [COPDSS], and Airways Questionnaire [AQ20]). Patients were followed-up until the appearance of the composite event or for 1 year, whichever came first. Results: A total of 497 patients were included in the study. The majority of them were men (89.7%), with a mean age of 68.7 (SD 9.2) years, and a forced expiratory volume in 1 second of 47.1% (SD 17.5%). A total of 303 (61%) patients experienced a composite event. Patients with an event had worse mean scores of all questionnaires at baseline compared to patients without event: CAT=12.5 vs 11.3 (P=0.028); CCQ=2.2 vs 1.9 (P=0.013); COPDSS=12.3 vs 10.9 (P=0.001); AQ20=8.3 vs 7.5 (P=0.048). In the multivariate analysis, only previous history of exacerbations and CAT score ≥13.5 were significant risk factors for the composite event. A CAT score ≥13.5 increased the predictive value of previous exacerbations with an area under the receiver operating characteristic curve of 0.864 (95% CI: 0.829-0.899; P=0.001). Conclusion: The predictive value of previous exacerbations significantly increased only in one of the four trialled questionnaires, namely in the CAT questionnaire. However, previous history of exacerbations was the strongest predictor of the composite event.
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It is part of: International Journal of Chronic Obstructive Pulmonary Disease, 2015, vol. 30, num. 10, p. 2571-2579
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ISSN: 1176-9106
Appears in Collections:Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil)

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