Specific COPD Assessment Test functional items, particularly lack of energy (OR 1.822; 95% CI 1.071-3.099; p<0.05), significantly predicted acute exacerbations within 90 days post-rehabilitation.
Cohort (n=76)
Do specific COPD Assessment Test (CAT) items predict acute exacerbations within 90 days following pulmonary rehabilitation in COPD patients?
Functional items on the COPD Assessment Test, particularly energy level, are significant predictors of acute exacerbation risk within 90 days following pulmonary rehabilitation.
Effect estimate: OR 1.822 (95% CI 1.071-3.099)
p-value: p=<0.05
Abstract Rationale Acute exacerbations (AE) in COPD patients cause functional decline, increased healthcare costs, and elevated mortality. While pulmonary rehabilitation (PR) is an effective non-pharmacological management for COPD patients, post-PR acute exacerbations remain a clinical concern. Currently, healthcare providers lack adequate scientific evidence to identify which patients remain at high risk for AE despite receiving PR. This study aims to investigate whether The COPD Assessment Test (CAT) scores and specific CAT items can predict acute exacerbations following pulmonary rehabilitation, which may inform risk stratification and personalized post-rehabilitation care planning. Methods This investigation employed a retrospective design utilizing hospital-based registry data spanning from January 2023 to December 2024. This study included all patients diagnosed with COPD who had received pulmonary rehabilitation. This study included all patients diagnosed with COPD who had received pulmonary rehabilitation. Patients were followed for 90 days to identify characteristics associated with AE occurrence within 3 months following PR. Results Following exclusion of patients with missing demographic data, ventilator dependence, lung cancer, PR received exclusively during hospitalization, or a single PR session, 76 participants were enrolled. Among these patients, 10 experienced AE within 90 days and were classified as the AE group, while 66 patients without AE were designated as the non-AE group. No significant differences were observed between the two groups in smoking status, comorbidities, GOLD stage, cardiac function, or lung function tests. Among the eight CAT items, four showed significant associations with AE risk: breathlessness when climbing stairs (item 4, OR = 1.668, 95% CI: 1.084-2.567), limitation of activities at home (item 5, OR = 1.562, 95% CI: 1.064-2.293), confidence in leaving home (item 6, OR = 1.532, 95% CI: 1.113-2.109), and lack of energy (item 8, OR = 1.822, 95% CI: 1.071-3.099), with all p 0.05. Energy level demonstrated the strongest association. Other CAT items, including cough, phlegm, chest tightness, and sleep quality, were not significantly associated with post-PR exacerbation risk. Conclusions The stronger associations observed with CAT’s functional items compared to respiratory symptoms indicate that functional capacity may serve as a more significant predictor of post-PR exacerbation risk, which has implications for targeted monitoring and intervention strategies. This abstract is funded by: None
C -L Tsai (Fri,) conducted a cohort in COPD (n=76). COPD Assessment Test (CAT) functional items was evaluated on Acute exacerbations within 90 days following pulmonary rehabilitation (OR 1.822, 95% CI 1.071-3.099, p=<0.05). Specific COPD Assessment Test functional items, particularly lack of energy (OR 1.822; 95% CI 1.071-3.099; p<0.05), significantly predicted acute exacerbations within 90 days post-rehabilitation.