COPD signs, symptoms and diagnosis
COPD progresses over time, and so its signs and symptoms depend on the stage of the disease. Common symptoms include:
- Persistent cough
- Chest tightness and breathlessness
- Sputum production
The symptoms for COPD reflect those of its 2 main contributing conditions:
1. Chronic bronchitis is a lasting inflammation of the airways characterised by excess sputum production and persistent cough.
2. Emphysema is the destruction of lung tissue in the alveoli, which causes respiratory insufficiency.
The clinical diagnosis of COPD takes into account the patient’s medical history, a physical examination, diagnostic imaging and pulmonary function tests.1
The most objective standard to assess airflow limitation is spirometry, which includes measurements of the FEV1 (forced expiratory volume in one second) and the FEV/FVC (forced expiratory volume/forced vital capacity) ratio – the most indicative measures for COPD diagnosis.1
The severity of a patient’s COPD can be predicted using the global initiative for chronic obstructive lung disease (GOLD) index,1 which is based on the patient’s pulmonary function.
Other COPD indices, such as the body mass, obstruction, dyspnoea and exercise capacity (BODE) index may also be used. The BODE Index uses a combination of patient assessments including BMI, FVC, FEV1, a 6-minute walk distance and a dyspnoea scale.7
COPD treatment and outcomes
Physicians treating COPD patients at home have a range of treatment options available. These include various medications, pulmonary rehabilitation and oxygen therapy. They may also consider adding non-invasive ventilation to improve patient quality of life and disease management.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). “Global Strategy for the Diagnosis, Management and Prevention of COPD, 2015.” (accessed November 9, 2015) Gold Report
2: World Health Organization. “Chronic respiratory diseases: Burden of COPD” (accessed November 9, 2015) http://www.who.int/gho/publications/world_health_statistics/en/
3: Lamprecht B et al. COPD in Never Smokers. Chest 2011;139(4):752–763.
4: Eisner MD et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010;182(5):693-718
5: Jencks SF et al. Rehospitalizations among patients in the Medicare fee-for-service program. New Engl J Med. 2009;360(14):1418-28.
6: Australian Institute of Health and Welfare. “COPD — chronic obstructive pulmonary disease: About COPD” Aihw.gov.au. (accessed November 9, 2015) http://www.aihw.gov.au/copd/
7: Celli BR et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:1005–12.