期刊
RESPIRATORY MEDICINE
卷 109, 期 12, 页码 1546-1552出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.rmed.2015.10.011
关键词
COPD; CAT; Exacerbations
资金
- Boehringer Ingelheim
- Pfizer
- AstraZeneca
- Chiesi
- GlaxoSmithKline
- Menarini
- Teva
- Boehringuer Ingelheim
- Almirall
- Esteve
- Gebro Pharma
- CLS Behring
- Medilmmune
- Takeda
- Grifols
- Novartis
Introduction: Since exacerbations of chronic obstructive pulmonary disease (COPD) cause both a great impact on the progression of the disease and generate high health expenditures, there is a need to develop tools to evaluate their prognosis. Method: Multicenter, observational, prospective study that evaluated the prognostic utility of the COPD Assessment Test (CAT) in severe exacerbations of COPD. Anthropometric and clinical variables were analyzed: smoking, history of exacerbations during the previous year, drug treatment, degree of baseline dyspnea, comorbidities; laboratory variables at admission (complete blood count, arterial blood gas and biochemistry) and CAT scores in the first 24 h of admission, on the third day, at discharge and at 3 months. Results: We evaluated 106 patients (91 males) with a mean age of 71.1 (SD 9.8 years), mean FEV1 45.2% (14.7%) and average CAT score at admission of 24.7 points (7.1). At three months after discharge, treatment failure was observed in 39 (36.8%) patients: 14 (13.2%) presented an exacerbation without the need for hospital admission, 22 were readmitted (20.8%) and 3 (2.8%) died during follow-up. The three factors associated with increased risk of failure were a reduction less than 4 units in the CAT at discharge compared to admission, lower hemoglobin levels and treatment with domiciliary oxygen. Conclusions: A change of <= 4 points in the CAT score at discharge compared to that obtained at admission due to a severe exacerbation of COPD, helps to predict therapeutic failure such as a new exacerbation, readmission or death in the subsequent three months. (C) 2015 Elsevier Ltd. All rights reserved.
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