Different Pattern of Chronic Obstructive Pulmonary Disease Assessment Test Score between Chronic Bronchitis and Non-chronic Bronchitis Patients

Yoo, Sun Hong; Lee, Jaeha; Yoo, Kwang Ha; Jung, Ki Suck; Rhee, Chin Kook

doi:10.4046/trd.2017.0088

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…These clinical characteristics of CB corresponded to those of patients with CB in previous studies. [12][13][14][15]29,32 Furthermore, the RV/ TLC was significantly higher in the CB group CB than the non-CB group classified according to the CAT definition (P<0.05). Although the same tendency was observed with the other definitions, it was not statistically significant in either case.…”

Section: Discussionmentioning

confidence: 99%

“…3 Goblet cell hyperplasia in the bronchial epithelium is an important pathophysiological mechanism underlying this phenotype, which results in hypersecretion of mucus leading to airway obstruction and a predisposition to bacterial colonization. 3,[9][10][11] Recent reports indicated that CB phenotype is associated with poor health-related quality of life, 3,[12][13][14][15] reduced lung function, 12,14 more frequent exacerbations, 3,7,12,14,16,17 and higher mortality rate. 14,16 These CB patients have been reported to constitute 14-74% of all COPD patients.…”

Section: Introductionmentioning

confidence: 99%

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CAT Score and SGRQ Definitions of Chronic Bronchitis as an Alternative to the Classical Definition

Choi¹,

Yoon²,

Shin³

et al. 2019

COPD

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Purpose: Previous studies have used various definitions to classify chronic obstructive pulmonary disease (COPD) patients into chronic bronchitis (CB) and non-CB patients. This study was performed to identify differences among three definitions of CB based on the classical method, St. George's Respiratory Questionnaire (SGRQ), and the CAT (COPD Assessment Test) score. Patients and methods: We extracted data from the multicenter Korea COPD Subgroup Study (KOCOSS) cohort, for which patients recruited from among 47 medical centers in South Korea beginning in April 2012. Patients were classified according to three different definitions of CB: 1) classical definition; 2) SGRQ (using questions regarding cough and sputum); and 3) CAT score (comprising cough [CAT1] and sputum [CAT2] subscale scores). Results: A total of 2694 patients were enrolled in this study. The proportions of CB were 10.8%, 35.8%, and 24.0% according to the classical, SGRQ, and CAT definitions, respectively. The three definitions yielded consistently significant differences between CB and non-CB patients in modified Medical Research Council dyspnea scale CAT score, SGRQ score, number of moderate-to-severe exacerbations per year and forced expiratory volume in 1 second. By three definitions, CB consistently predicted future risk of exacerbation. The kappa coefficient of agreement between the classical definition and SGRQ definition was 0.29, that of the classical definition and CAT definition was 0.32, and that of the SGRQ definition and CAT definition was 0.44. Conclusion: Patients with CB according to the new definitions based on SGRQ or CAT score showed similar clinical characteristics to those defined according to the classical definition. The new CB definitions may be used as alternatives to the classical definition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CAT Score and SGRQ Definitions of Chronic Bronchitis as an Alternative to the Classical Definition

Choi¹,

Yoon²,

Shin³

et al. 2019

COPD

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“…33 CAT scores for patients with chronicbronchitis-type and chronic-bronchitis-free-type COPD were investigated, and they were higher for responses to all of the eight questions in chronic-bronchitis-type, although there were no differences in lung function. 34 Since the proportion of current smokers was high (41.8%) among subjects with chronic cough and phlegm, smoking cessation is necessary in addition to medical treatment. The proportion of subjects who attempted to quit smoking in the past year was 23.0% in Japan, 35 which was lower than that in the United Kingdom 36 and the United States.…”

Section: Discussionmentioning

confidence: 99%

Chronic Cough and Phlegm in Subjects Undergoing Comprehensive Health Examination in Japan – Survey of Chronic Obstructive Pulmonary Disease Patients Epidemiology in Japan (SCOPE-J)

Omori

Higashi

Nawa

et al. 2020

COPD

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Purpose: The purpose of this study was to estimate the prevalence of subjects with chronic cough and phlegm and describe their characteristics including the presence or absence of airflow limitation among the general population in Japan. Subjects and Methods: This was an observational cross-sectional survey targeting multiple regions of Japan. Subjects aged 40 years or above who were undergoing comprehensive health examination were recruited. The existence of chronic cough and phlegm, airflow limitation, and treatment for respiratory diseases were examined. Chronic cough and phlegm were defined as having both symptoms for at least 3 months of the year and for at least 2 consecutive years, or as receiving any treatment for chronic bronchitis at the time of recruitment. Airflow limitation was defined as forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) less than 0.7. Results: In a total of 22,293 subjects, 380 subjects (1.7%) had chronic cough and phlegm. Among these 380 subjects, 21.8% received treatment for a respiratory disease, and 11.6% had airflow limitation. Compared to subjects without both chronic cough and phlegm but with airflow limitation, subjects with chronic cough and phlegm without airflow limitation were younger, more likely to be current smokers (39.6%), and had higher total scores on a chronic obstructive pulmonary disease (COPD) assessment test (CAT). Scores of CAT questions 1-4 (cough, phlegm, chest tightness, breathlessness, respectively) were higher in subjects with chronic cough and phlegm regardless of airflow limitation. Conclusion: This study demonstrated that subjects identified to have chronic cough and phlegm in comprehensive health examination settings were symptomatic, while most of them did not receive any treatment for respiratory diseases and did not have airflow limitation. Screening subjects for chronic cough and phlegm in a comprehensive health examination followed by a detailed examination of screened subjects could be an effective approach for better management of chronic cough and phlegm. Smoking cessation should be included in the management, in consideration that around 40% of subjects with chronic cough and phlegm were current smokers.

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“…Chronic bronchitis patients with COPD are characterized by airway wall thickening as detected via thoracic CT. 6,14 Such patients are often more symptomatic and show more frequent exacerbations compared to patients without chronic bronchitis. [24][25][26][27] Furthermore, MWA% is also correlated with small airway disease, 10 and it may also have had a detrimental effect on COPD patients with mixed phenotype. We found that frequent exacerbations in the mixed phenotype may have led to increased mortality, consistent with previous studies.…”

Section: Discussionmentioning

confidence: 99%

Mixed Phenotype of Emphysema and Airway Wall Thickening Is Associated with Frequent Exacerbation in Chronic Obstructive Pulmonary Disease Patients

Lim¹,

Kim²,

Lim³

et al. 2019

COPD

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Objective: The presence of both emphysema and airway wall thickening determined via volumetric computed tomography (CT) is defined as mixed phenotype. The long-term clinical course of this phenotype has not been studied in depth. This study compared the mixed phenotype to other phenotypes of chronic obstructive pulmonary disease (COPD) patients. Methods: COPD patients enrolled in the Korean Obstructive Lung Disease (KOLD) study from June 2005 to October 2015 were evaluated. The emphysema index and the percentage of bronchial mean wall area were calculated from volumetric CT scans. Patients with COPD were classified into four phenotypes using two cutoffs: emphysema index of 15% and median value of mean wall area (MWA%). Results: Of 435 patients with COPD, 99 (22.8%) were defined as CT-normal type, 119 (27.4%) as emphysema-dominant type, 113 (26.0%) as airway-dominant type, and 104 (23.9%) as mixed type. The mixed phenotype showed the highest baseline total COPD Assessment Test (CAT) and St. George's Respiratory Questionnaire (SGRQ) scores. Moreover, it had the highest proportion of patients experiencing exacerbation of COPD (50.0%), and had the lowest baseline FEV1. Lower BMI, GOLD stages III-IV, and mixed phenotype were significant factors associated with severe exacerbation frequency in univariate analyses. Multivariate analyses showed that lower BMI and CT phenotype were significant factors associated with severe exacerbation frequency. Compared to the CT-normal phenotype, the mixed phenotype was significantly associated with more frequent severe exacerbation (IRR 4.134, P=0.031). Conclusion: Patients with mixed phenotype are more symptomatic, have poorer pulmonary function, and are associated with more frequent severe exacerbation. Plain Language SummaryPatients with mixed phenotype of emphysema and airway wall thickening are more symptomatic, have poorer pulmonary function, and are associated with more frequent severe exacerbation.

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Different Pattern of Chronic Obstructive Pulmonary Disease Assessment Test Score between Chronic Bronchitis and Non-chronic Bronchitis Patients

Cited by 7 publications

References 19 publications

<p>CAT Score and SGRQ Definitions of Chronic Bronchitis as an Alternative to the Classical Definition</p>

<p>CAT Score and SGRQ Definitions of Chronic Bronchitis as an Alternative to the Classical Definition</p>

<p>Chronic Cough and Phlegm in Subjects Undergoing Comprehensive Health Examination in Japan – Survey of Chronic Obstructive Pulmonary Disease Patients Epidemiology in Japan (SCOPE-J)</p>

<p>Mixed Phenotype of Emphysema and Airway Wall Thickening Is Associated with Frequent Exacerbation in Chronic Obstructive Pulmonary Disease Patients</p>

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