| Objectives To investigate the correlation between CAT score and BODE index in elderly patients with chronic obstructive pulmonary disease(COPD).To analyse the efficacy of CAT score in evaluating the condition of elderly COPD patients and the consistency with the BODE index evaluation results.To provides a more simple and economical method for judging the condition and prognosis of elderly patients with COPD.Methods A total of 124 elderly COPD patients who received treatment and received medication in the Department of Geriatrics,Affiliated Hospital of North China University of science and technology,were collected from October 2016 to May 2017.We selected 77 cases of standard patients.Among them,51 cases were male,accounting for 66.23%,26 cases were female,accounting for 33.77%.The youngest patient was 60 years old,the oldest was 84 years old,the average age was 65.7±6.18 years old..Calculate the patient’s COPD assessment test(CAT)score and BODE index at admission.The patients were divided into groups with BODE index ≥5,namely the case group(n=40)and BODE index < 5 group,namely the control group(n=37).All research materials use Excel2003 to establish database and use SPSS 22.0 statistical software for data analysis.Observe whether the measurement data conform to the normal distribution.The data of normal distribution are expressed by? sx ±.Paired sample t test was used for comparison between groups.Use case number or constituent ratio representation for counting data.Inter group comparison using chi square test.Drawing the ROC curve to analyze the accuracy.finding the best critical value —cut-off value.The consistency analysis was applied to Kappa test.The difference of P< 0.05 was statistically significant.Results 1.Paired sample t test showed that there was no significant difference in gender and age between case group and control group(P>0.05).There was difference between case group and control group in smoking history(P < 0.05).2.The effect of CAT score on the outcome of BODE index: the CAT score of the case group was 26.80±3.98,the CAT score in the control group was 16.41±5.72.The CAT score in the case group was significantly higher than that in the control group(P < 0.01).3.The relationship between CAT score and the outcome of BODE index: the average number of CAT scores in the case group and the control group was 21.81,while the CAT score greater than the mean value was significantly correlated with the BODE index(P < 0.01),the OR value was 105.30,and the 95% confidence interval was(12.723,871.481).4.ROC working curve: the area under the curve of the CAT score was 0.994,(95% CI= 0.897~0.995,P < 0.01).The results showed that compared with the results of the BODE index,the CAT score was more effective in evaluating the condition of the elderly patients with COPD,and the results of the two were almost identical.5.Screening and evaluation of cut-off: according to the sensitivity,specificity and the value of the Jordan index.The largest point of the Jordan index is chosen as the boundary value of the screening.The results showed that when the CAT score was 23.5,the Jordan index is the largest.The Jordan index is 0.769,the sensitivity is 85%,and the specificity is 91.9%.When the CAT score was 22.5,the Jordan index was next to the maximum value,and the sensitivity of the score increased obviously at 89.3%,and the specificity was 83.8%.So 22.5 is selected as the critical value of CAT.The Kappa coefficient was 0.765,and the crude accuracy rate was 88.3%,which was statistically significant.Because the Kappa coefficient is greater than 0.7,and the accuracy rate is higher,CAT score can replace BODE index in clinic.Conclusions 1.When the patients were in the stable period of COPD,the CAT score was significantly correlated with the BODE index.The change of the score of the CAT score and the BODE index were in good agreement with the change of the patient’s condition.CAT score is an effective,sensitive and feasible method to evaluate the quality of life of COPD patients. |
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