The role of inflammatory biomarkers and health related quality of life questionnaires on diagnosis of exacerbation and stable COPD

COPD is a preventable and treatable illness that is one of the most common causes of chronic morbidity and mortality. Natural course of COPD is characterized with repetitive symptoms and exacerbations. Exacerbation diagnosis is made according to patients' anamneses and subjective symptoms. As well as there is not any objective and definite parameters for diagnosis, new physical examination findings and inflammatory biomarkers can mostly be a guide at clinical practice. By taking the effects of exacerbations on life quality, in this study, we aimed to show usefullness of CAT at exacerbation diagnosis and during exacerbation period. CAT scores and inflammatory biomarkers of COPD patients who applied to the hospital at the time of exacerbation, were compared with CAT scores and inflammatory biomarkers at stable period of the patients in this study. Thereby it was aimed to evaluate whether CAT scores of COPD patients can be usefull in distinguishing exacerbation and stable period or not. Also correlation of the change in CAT score of the patients between exacerbation and stable periods with MPV, İl-6, CRP and general health survey SF-36 was examined. 13 women and 40 men as total 53 COPD patients who applied to our hospital on exacerbation were included in the study. Average age of the patients were 68,6±1,1 years. CAT scores of the patients at stable period after exacerbation was lower than CAT scores of exacerbation period. (mean CAT exacerbation: 23,2±1,7 and meanCAT stable: 15,0±1,0 p<0,01). Likewise it was seen that there was a progression on SF-36 physical health scores at stable period after exacerbation when compared with exacerbation (p<0,05). It was founded that CAT scores of exacerbation correlated with il-6 (rho=0,45 p= 0,01), CRP (rho=0,45 p= 0,01 ) and leucocytes (rho=0,30 p=0,03) measured at exacerbation. But CAT scores and MPV values didn't correlate. Also, CAT scores of stable period after exacerbation and the number hospital applications done due to exacerbations in last 1 year correlated (rho= 0,41 p=0,02). We suggest that as a result of our study, CAT can be a usefull guide at exacerbation diagnosis with regard to its correlation between inflammatory biomarkers like CRP and il-6. We also think that, it can be a usefull guide for diagnosis of patients especially whom it is hard to evaluate with rise in biomarkers due to the existence of comorbidities that already cause an inflammatory response. As a result of our study, we suggest that CAT is a non-invasive and costless tool for follow-up of exacerbation period.