Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Jun 19;10:1199-205.
doi: 10.2147/COPD.S82910. eCollection 2015.

Influence of Pulmonary Emphysema on COPD Assessment Test-Oriented Categorization in GOLD Document

Affiliations
Free PMC article
Comparative Study

Influence of Pulmonary Emphysema on COPD Assessment Test-Oriented Categorization in GOLD Document

Toshio Suzuki et al. Int J Chron Obstruct Pulmon Dis. .
Free PMC article

Abstract

Background: The COPD assessment test (CAT) score is a key component of the multifactorial assessment of COPD in the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines of 2014. Nevertheless, little is known regarding the differences among COPD categories in terms of clinical parameters such as pulmonary function or radiological findings. Thus, our aims in this study were to evaluate the associations between CAT scores and pulmonary clinical parameters, and to investigate factors that could discriminate between a "less symptomatic group" (categories A and C) and a "more symptomatic group" (categories B and D) among stable COPD patients.

Methods: We enrolled 200 outpatients at Chiba University Hospital. Study subjects were assessed by CAT, pulmonary function testing, and multidetector computed tomography (MDCT). We assessed possible correlations between these indices.

Results: CAT scores were negatively correlated with percentage of the forced expiratory volume in 1 second predicted value (FEV1 %predicted) and percentage of the diffusing capacity for carbon monoxide per liter of lung volume predicted value (DLCO/VA [%predicted]) results and positively correlated with low attenuation volume percentage (LAV%) and residual volume to total lung capacity ratios (RV/TLC). In the "more symptomatic group" (category B or D), the mean DLCO/VA (%predicted) was significantly lower and the mean LAV% and RV/TLC was significantly higher than those in the "less symptomatic group" (category A or C), respectively. Interestingly, those in category B had higher mean LAV% compared to those in category C.

Conclusion: CAT scores were significantly correlated with pulmonary function parameters and emphysematous changes on MDCT. The new GOLD classification system would be a step toward a phenotypic approach, especially taking into account the degree of emphysema and hyperinflation.

Keywords: COPD assessment test; diffusing capacity; emphysema; residual volume ratio.

Figures

Figure 1
Figure 1
Flow chart for study participants. Abbreviation: GOLD, Global initiative for chronic Obstructive Lung Disease.
Figure 2
Figure 2
Correlations between CAT scores and PFT parameters and MDCT parameters. Notes: (A) Correlation between CAT score and FEV1 (%predicted). (B) Correlation between CAT score and DLCO/VA (%predicted). (C) Correlation between CAT score and LAV%. Abbreviations: CAT, chronic obstructive pulmonary disease assessment test; DLCO/VA (%predicted), percentage of the diffusing capacity for carbon monoxide per liter of lung volume predicted value; FEV1 (%predicted), percentage of the FEV1 predicted value; LAV%, low attenuation volume percentage; FEV1, forced expiratory volume in 1 second; PFT, pulmonary function test; MDCT, multidetector computed tomography.

Similar articles

See all similar articles

Cited by 1 article

References

    1. Kim S, Oh J, Kim YI, et al. Differences in classification of COPD group using COPD assessment test (CAT) or modified Medical Research Council (mMRC) dyspnea scores: a cross-sectional analyses. BMC Pulm Med. 2013;13:35. - PMC - PubMed
    1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: Revised 2011. [Accessed February 12, 2015]. Available from: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2014_Jun11.pdf.
    1. Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–365. - PubMed
    1. Jones PW. The COPD Assessment Test: what have we learned over its first 5 years? Eur Respir J. 2014;44(4):833–834. - PubMed
    1. Jones PW, Adamek L, Nadeau G, Banik N. Comparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification. Eur Respir J. 2013;42(3):647–654. - PubMed

Publication types

MeSH terms

Feedback