Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases. COPD is a leading and increasing cause of death, both in the US and worldwide.
A diagnosis of COPD should be considered in any patient who has dyspnea, chronic cough or sputum production, and/or a history of exposure to risk factors for the disease, especially cigarette smoking.
Consider COPD, and perform spirometry, if any of the following indicators are present in an individual over age 40. These indicators are not diagnostic themselves, but the presence of multiple key indicators increases the probability of a diagnosis of COPD.
- Chronic cough
- Chronic sputum production
- History of exposure to risk factors: tobacco smoke, occupational dust and chemicals, and smoke from home cooking and heating fuels.
Why do Spirometry for COPD?
- Spirometry is needed to make a firm diagnosis of COPD.
- Together with the presence of symptoms, spirometry helps stage COPD severity and can be a guide to specific treatment steps.
- A normal value for spirometry effectively excludes the diagnosis of clinically relevant COPD.
- The lower the percentage predicted FEV1, the worse the subsequent prognosis.
- FEV1 declines over time and faster in COPD than in healthy subjects. Spirometry can be used to monitor disease progression, but to be reliable the intervals between measurements must be at least 12 months.
GOLD Guidelines for COPD
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with health care professionals and public health officials to raise awareness of COPD and to improve prevention and treatment of this lung disease for patients around the world. GOLD guidelines state a COPD diagnosis should be confirmed by spirometry.