Study On The Differences Of Common Clinical Scores Of COPD And Their Correlation With Pulmonary Function

Objective(s):SGRQ,CAT,CCQ,mMRC and 6MWT were selected to assess the condition of patients with stable COPD.By compared and analyzed the relations and differences among the five scoring methods,as well as the correlation between each method and pulmonary ventilation function,so as to explore a more suitable scoring method for clinical.Methods:According to inclusion and exclusion criterias,60 patients with stable COPD who visited the Outpatient Department of Respiratory and Critical Care Medicine,Calmette Hospital Affiliated to Kunming Medical University from January to December 2019 were selected in the study.All research objects successively completed CAT,mMRC,CCQ,SGRQ,pulmonary ventilation function test and 6MWT.And then they were grouped according to age,smoking status,with or without complications,and GOLD grade to study the differences of each scoring method in assessing different groups,and to assess the internal consistency of SGRQ,CAT,and CCQ scores,analyzed the correlation between each score and FEV1/FVC,FEV1%pred,FEV1,FVC,PEF,and explored the cut-off values of the four scoring methods of CAT,mMRC,SGRQ,and CCQ and investigated the consistency of the four scoring methods by GOLD grouping.Results:1.According to different age groups and with or without complications,the differences in CAT,mMRC,CCQ,SGRQ,6MWT,FEV1/FVC,FEV1%pred,FEV1,FVC and PEF were found no statistically differences among stable COPD patients(P>0.05).According to different smoking status,the differences in mMRC were found statistically differences(P<0.05),while the differences in CAT,CCQ,SGRQ,6MWT;FEV1/FVC,FEV1%pred,FEV1,FVC and PEF were no statistically differences(P>0.05).According to different GOLD classification groups,the differences in CAT,mMRC,CCQ,SGRQ and 6MWT were found statistically differences among stable COPD patients(P<0.05).2.The Cronbach's alpha of CAT,SGRQ,and CCQ were 0.883,0.896,and 0.771,respectively.3.The CAT with SGRQ,CCQ,mMRC showed highly positive correlation(r=0.778,0.838,0.754,P<0.01),with 6MWD showed moderate negative correlation(r=0.639,P<0.01).The SGRQ with CCQ showed highly positive correlation(r=0.829,P<0.01),and with mMRC showed moderate positive correlation(r=0.631,P<0.01),and with 6MWD showed moderate negative correlation(r=0.627,P<0.01).CCQ with mMRC showed moderate positive correlation(r=0.682,P<0.01),and with 6MWD showed moderate negative correlation(r=-0.605,P<0.01).There was a high negative correlation between mMRC and 6MWD(r=-0.759,P<0.01).4.FEV1/FVC,FEV1%pred,FEV1,and PEF were negatively correlated with CAT,SGRQ,CCQ,and mMRC,respectively,and positively correlated with 6MWD.And FEV1/FVC,FEV1%pred,and FEV1 had the best correlation with CAT,PEF had the best correlation with 6MWD.FVC had a low negative correlation with CAT,SGRQ,and CCQ,a low positive correlation with 6MWD,and no correlation with mMRC.5.The results of grouping A,B,C,D by using CAT(cut-off value 10),CAT(cut-off value 15),CAT(cut-off value 17),SGRQ(cut-off value 25),mMRC(cut-off value 2),CCQ(cut-off value 1.0),CCQ(cut-off value 1.5)were not completely consistent.The grouping kappa values for the CAT(cut-off value 10),CAT(cut-off value 15),CAT(cut-off value 17)and mMRC(cut-off value 2)groups were 0.621,0.744,0.766,respectively,and 0.688,0.606,and 0.505 for the SGRQ(cut-off value 25)group,0.5,0.372,and 0.296 for the CCQ(cut-off value 1.0)group,and 0.639,0.645,and 0.586 for the CCQ(cut-off value 1.5)group.The grouping kappa values for the mMRC(cut-off value 2)and SGRQ(cut-off value 25)group was 0.504.The grouping kappa values for the mMRC(cut-off value 2)and CCQ(cut-off value 1.0)and CCQ(cut-off value 1.5)group were 0.329 and 0.541 respectively.The grouping kappa values for the SGRQ(cut-off value 25),CCQ(cut-off value 1.0)and CCQ(cut-off value 1.5)groups were 0.607,0.799,respectively.Conclusion(s):1.mMRC maybe more appropriate for assessment of dyspnea in stable COPD patients with a history of smoking.2.SGRQ,CAT and CCQ are highly reliable questionnaires for the assessment of the health status of patients with COPD.3.CAT or CCQ score is more appropriate for the daily comprehensive assessment of the condition of patients with COPD.And 6MWT has a certain supplement for the assessment of activities of daily living in patients with COPD.4.There are good correlation between scoring method and pulmonary function,so scoring method can be used to supplement the pulmonary function,and the CAT is preferred.And PEF combined with 6MWT may be a simple and cost-effective monitoring method for patients with COPD.5.When adopting CCQ,1.5 as the cut-off value maybe more appropriate,that still need to further expand the sample size to study.