# COPD Assessment Test Score Deterioration as a Predictor of Long-Term Outcomes in Patients Hospitalised for Chronic Obstructive Pulmonary Disease Exacerbation

## TL;DR

This study shows that larger increases in COPD Assessment Test scores during severe COPD flare-ups predict more frequent healthcare use, suggesting the need for closer monitoring.

## Contribution

The study introduces CAT score deterioration as a novel predictor of healthcare resource utilization after COPD exacerbations.

## Key findings

- Patients with higher CAT score deterioration had earlier emergency room visits and hospitalizations.
- Survival rates did not differ significantly across tertiles of CAT score changes.
- 60% of participants were male, with an average age of 70.5 years.

## Abstract

Background: While severe exacerbations are known to worsen the prognosis of patients with chronic obstructive pulmonary disease (COPD), the extent of this impact based on the degree of deterioration is unclear. COPD Assessment Test (CAT) scores increase during exacerbations, reflecting symptom worsening. This study aimed to compare healthcare resource utilisation and mortality among patients with COPD after a severe exacerbation, stratified by changes in CAT scores. Methods: This observational study included patients hospitalised for COPD exacerbation. The CAT questionnaire was administered twice: once referring to the time of admission and once to the stable phase. Patients were divided into tertiles based on symptom worsening. A prospective follow-up was conducted to compare emergency room visits, hospital admissions, and survival rates. Results: This study included 50 patients, of whom 30 (60%) were male. Their mean age was 70.5 years (standard deviation [SD]: 9.6), mean forced expiratory volume in the first second (FEV1) was 46.7% (SD: 0.8) of the predicted value, and median CAT score deterioration was 9 points (interquartile range: 5–15.25). Patients in the third tertile had earlier healthcare utilisation than those in the first tertile (emergency room visits: log-rank = 5.27, p = 0.022; hospitalisations: log-rank = 5.27, p = 0.022). Survival rates did not differ significantly among tertiles. Conclusions: Patients with greater CAT score deterioration experienced earlier COPD-related events, suggesting the need for closer monitoring after severe exacerbation.