Ciro Casanova1, Jose M Marin2, Cristina Martinez-Gonzalez3, Pilar de Lucas-Ramos4, Isabel Mir-Viladrich5, Borja Cosio6, German Peces-Barba7, Ingrid Solanes-García8, Ramón Agüero9, Nuria Feu-Collado10, Miryam Calle-Rubio11, Inmaculada Alfageme12, Alfredo de Diego-Damia13, Rosa Irigaray14, Margarita Marín15, Eva Balcells16, Antonia Llunell17, Juan Bautista Galdiz18, Rafael Golpe19, Celia Lacarcel20, Carlos Cabrera21, Alicia Marin21, Joan B Soriano22, Jose Luis Lopez-Campos23, Juan José Soler-Cataluña24, Juan P de-Torres25. 1. Pulmonary Department, Hospital Universitario Nuestra Señora de Candelaria, Tenerife. Electronic address: casanovaciro@gmail.com. 2. Pulmonary Department, Hospital Universitario Miguel Servet, Zaragoza; Pulmonary Department, Hospital Universitario Germans Trias y Pujol, Badalona, Barcelona. 3. Pulmonary Department, Hospital Universitario Central de Asturias, Oviedo. 4. Pulmonary Department I, Hospital General Universitario Gregorio Marañón, Madrid. 5. Pulmonary Department, Hospital Son Llátzer, Mallorca. 6. Pulmonary Department, Hospital Universitario Son Espases-IDISPA, Palma de Mallorca; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid. 7. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid; Pulmonary Department, Hospital Universitario Fundación Jiménez Díaz, Madrid. 8. Pulmonary Department, Hospital de la Santa Creu i Sant Pau, Barcelona. 9. Pulmonary Department, Hospital Universitario Marqués de Valdecilla, Santander. 10. Pulmonary Department, Hospital Universitario de Valme, Sevilla; Pulmonary Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba. 11. Pulmonary Department, Hospital Universitario Clinico San Carlos, Madrid. 12. Pulmonary Department, Hospital Universitario de Valme, Sevilla. 13. Pulmonary Department, Hospital Universitario y Politécnico de la Fe, Valencia. 14. Pulmonary Department, Hospital de Manacor, Mallorca. 15. Pulmonary Department, Hospital General de Castellon, Castellon. 16. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid; Pulmonary Department, Hospital del Mar, Barcelona. 17. Pulmonary Department, Hospital de Tarrasa, Tarrasa. 18. Pulmonary Department, Hospital Universitario de Cruces, Bilbao. 19. Pulmonary Department, Hospital General de Calde, Lugo. 20. Pulmonary Department, Hospital Ciudad de Jaén, Jaén. 21. Pulmonary Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria. 22. Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Cátedra UAM-Linde, Madrid. 23. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid; Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla. 24. Pulmonary Department, Hospital Universitario Arnau de Vilanova, Valencia. 25. Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain.
Abstract
OBJECTIVE: The modified Medical Research Council (mMRC) dyspnea, the COPD Assessment Test (CAT), and the Clinical COPD Questionnaire (CCQ) have been interchangeably proposed by GOLD (Global Initiative for Chronic Obstructive Lung Disease) for assessing symptoms in patients with COPD. However, there are no data on the prognostic value of these tools in terms of mortality. We endeavored to evaluate the prognostic value of the CAT and CCQ scores and compare them with mMRC dyspnea. METHODS: We analyzed the ability of these tests to predict mortality in an observational cohort of 768 patients with COPD (82% men; FEV1, 60%) from the COPD History Assessment in Spain (CHAIN) study, a multicenter observational Spanish cohort, who were monitored annually for a mean follow-up time of 38 months. RESULTS: Subjects who died (n = 73; 9.5%) had higher CAT (14 vs 11, P = .022), CCQ (1.6 vs 1.3, P = .033), and mMRC dyspnea scores (2 vs 1, P < .001) than survivors. Receiver operating characteristic analysis showed that higher CAT, CCQ, and mMRC dyspnea scores were associated with higher mortality (area under the curve: 0.589, 0.588, and 0.649, respectively). CAT scores ≥ 17 and CCQ scores > 2.5 provided a similar sensitivity than mMRC dyspnea scores ≥ 2 to predict all-cause mortality. CONCLUSIONS: The CAT and the CCQ have similar ability for predicting all-cause mortality in patients with COPD, but were inferior to mMRC dyspnea scores. We suggest new thresholds for CAT and CCQ scores based on mortality risk that could be useful for the new GOLD grading classification. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
OBJECTIVE: The modified Medical Research Council (mMRC) dyspnea, the COPD Assessment Test (CAT), and the Clinical COPD Questionnaire (CCQ) have been interchangeably proposed by GOLD (Global Initiative for Chronic Obstructive Lung Disease) for assessing symptoms in patients with COPD. However, there are no data on the prognostic value of these tools in terms of mortality. We endeavored to evaluate the prognostic value of the CAT and CCQ scores and compare them with mMRC dyspnea. METHODS: We analyzed the ability of these tests to predict mortality in an observational cohort of 768 patients with COPD (82% men; FEV1, 60%) from the COPD History Assessment in Spain (CHAIN) study, a multicenter observational Spanish cohort, who were monitored annually for a mean follow-up time of 38 months. RESULTS: Subjects who died (n = 73; 9.5%) had higher CAT (14 vs 11, P = .022), CCQ (1.6 vs 1.3, P = .033), and mMRC dyspnea scores (2 vs 1, P < .001) than survivors. Receiver operating characteristic analysis showed that higher CAT, CCQ, and mMRC dyspnea scores were associated with higher mortality (area under the curve: 0.589, 0.588, and 0.649, respectively). CAT scores ≥ 17 and CCQ scores > 2.5 provided a similar sensitivity than mMRC dyspnea scores ≥ 2 to predict all-cause mortality. CONCLUSIONS: The CAT and the CCQ have similar ability for predicting all-cause mortality in patients with COPD, but were inferior to mMRC dyspnea scores. We suggest new thresholds for CAT and CCQ scores based on mortality risk that could be useful for the new GOLD grading classification. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
Authors: Lucas M Donovan; Carol A Malte; Laura J Spece; Matthew F Griffith; Laura C Feemster; Ruth A Engelberg; David H Au; Eric J Hawkins Journal: Ann Am Thorac Soc Date: 2019-01
Authors: Heleen Demeyer; Elena Gimeno-Santos; Roberto A Rabinovich; Miek Hornikx; Zafeiris Louvaris; Willem I de Boer; Niklas Karlsson; Corina de Jong; Thys Van der Molen; Ioannis Vogiatzis; Wim Janssens; Judith Garcia-Aymerich; Thierry Troosters; Michael I Polkey Journal: PLoS One Date: 2016-03-14 Impact factor: 3.240