COPD
Diagnosis of COPD
COPD is often under-recognized and underdiagnosed, with patients themselves underestimating their symptoms and attributing them to be an effect of smoking, ageing or occupational exposure.1,2 This results in many patients being diagnosed late in the course of their disease – if at all.2,3
A diagnosis of COPD should be considered based on signs, symptoms and history and confirmed clinically with spirometry.1,4
COPD should be considered in patients over the age of 35 years with any of these key indicators:1,4
Physical examination (persistent, progressive dyspnea that worsens with exercise, chronic cough or sputum production)
Recurrent respiratory tract infections
History of risk factors:
- Host factors (genetic factors or developmental abnormalities)
- Exposure to tobacco smoke, fuels and occupational dusts
Family history of COPD and/or childhood factors (e.g. low birthweight and childhood respiratory infections)
Spirometry should be performed to confirm airflow obstruction and a diagnosis of COPD:1
- Airflow obstruction is defined by a post bronchodilator FEV1/FVC < 70%
References
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Global Strategy for the Diagnosis, Management, and Prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2021.
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Barnes PJ et al. Nat Rev Dis Primers 2015;1:15076.
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NHS Blog (Dr Penny Woods). World COPD Day – Don’t ignore the symptoms. https://www.england.nhs.uk/blog/world-copd-day-dont-ignore-the-symptoms/. Accessed 03 May 2021.
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NICE guideline [NG115]. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. https://www.nice.org.uk/guidance/ng115. Accessed 03 May 2021.