Comparison of modified medical research council scale and COPD assessment test in subjects with COPD

Abstract

Background: COPD is characterized by persistent airflow limitation. FEV1 and FVC are not good predictors of exercise tolerance, dyspnea and quality of life. The GOLD 2011 document proposed a new classification system for COPD combining symptom, exacerbation risk and Lung function. For assessing symptoms, GOLD 2011 recommends the use of the Modified Medical Research Council (mMRC) scale or the COPD Assessment Test (CAT). The aim of our study is whether the assignment of a patient in a group could change depending on the symptom scale that is used. Material and method: observational prospective cohort study of subjects with COPD. Inclusion Criteria: FEV1/FVC post-BD: 10 packs/years. We categorize patients into: A: low risk, less symptoms; B: low risk, more symptoms; C: high risk, less symptoms; D: high risk, more symptoms. Subjects were classified twice according to CAT questionnaire and mMRC scale. Results: We included 42 subjects with a mean age of 67 years, 71.4% were men. The mean FEV1 was 65 and mean IMC was 28. The mean packs/years was 54.14 and twenty three subjects (54.8) were former smokers. Twenty seven subjects (64%) were low risk according to GOLD criteria (lung function, number of exacerbations and hospitalizations). By using mMRC scale, 24 (57.1%) subjects were assigned to group A, 3 (7.1%) to group B, 7 (16.7%) to group C, and 8 (79%) to group D. By using CAT score, 16 (38.1%) patients were assigned to group A, 11 (26.2%) to group B, 6 (14.3%) to group C, and 9(21%) to group D. Conclusions: Our study suggests the fact of using mMRC scale or CAT scores, may influence the treatment and classification of our patients according to GOLD guidelines.