CAT Score as a prognostic tool in low resource setting: Exploring the correlation between CAT Score, Exacerbation history with BODE Index

Chronic Obstructive Pulmonary Disease (COPD) is a significant global health concern, projected to be the fourth leading cause of death by 2030. This study explores the correlation between the COPD Assessment Test (CAT) score, history of exacerbations and the BODE Index in stable COPD patients. While the BODE Index is a validated multidimensional grading system, its application in outpatient settings, especially in resource-constrained countries, can be challenging due to the need for spirometry. We conducted an observational cross sectional study, over 18 months in Mumbai, that recruited 50 stable COPD patients. The CAT score and history of exacerbations in previous one year were evaluated alongside the BODE Index and other demographic data. In the study population, the mean rate of exacerbation observed was 1.52 (SD=2.279) per person per year and the mean CAT score was 9.88±7.34 (range 0 to 27). The median BODE Index was 3. Correlations of r (Pearson’s)=0.468 (p = 0.000614) was observed between CAT score and BODE Index and σ (Spearman’s) = 0.2797 (p=0.0490) was observed between exacerbation history and BODE Index. These indicate moderate positive correlation between CAT score and BODE Index and statistically significant, albeit weak, correlation between exacerbation history and BODE Index. Our findings suggest that simple tools like CAT and exacerbation history can be used as surrogates for BODE Index particularly in low and middle income countries like India.