Functional Status of Patients with COPD Assessed by London Chest Activity of Daily Living Scale: Gender Association and Validity of a Cutoff Point

Purpose Whether the difference in the impact of chronic obstructive pulmonary disease (COPD) on the functional status of men and women stems from clinical distinctions or to the measuring instrument used is unclear. Like most instruments for assessing functional limitation in COPD, the interpretation of the results of the London Chest Activity of Daily Living (LCADL) scale is limited because a lack of a valid cutoff point to this scale. For that, this study sought to compare the functional status between men and women with COPD; and propose a cutoff point for LCADL capable of discriminating the prognosis of these individuals. Methods A sample of 138 subjects with moderate–severe COPD was evaluated by the LCADL. The percentage of the individual maximum score was used to obtain a cutoff point capable of discriminating patients with the worse prognosis according to the BODE Index. The cutoff point was also tested in an independent sample ( n = 70). Results Regarding the total score, domestic and leisure domains of the LCADL, men had better scores than women ( P ≤ 0.01). The cutoff point found was 37% (area under the curve = 0.70, 95% confidence interval = 0.60–0.80, sensitivity = 0.55 and specificity = 0.74). Individuals who scored ≥ 37% had a worse prognosis and level of physical activities of daily living than those who scored below ( P ≤ 0.02). Conclusion When evaluated by the LCADL, men and women with COPD present difference in the functional status. The established cutoff point (37%) adequately discriminates individuals regarding the prognosis, contributing to improve the interpretation capacity of the LCADL.