Chronic
obstructive pulmonary disease (COPD) is a major health epidemic, which
has important
consequences for patients and community, and still receives insufficient
attention from
the health care professionals and scientists. COPD is a leading cause of
chronic morbidity
(affects 210 million people) and mortality (causes 3 million deaths per
year) worldwide, and according to the World Health Organization (WHO),
it is the fifth most common cause
of death and the 10th most burdensome disease.
The first definition of chronic obstructive pulmonary disease (COPD) can
be found in the 60’s
and incorporates both terms “emphysema” and “chronic bronchitis”.
According to the Global Initiative for obstructive lung diseases (GOLD),
COPD is defined
as a “preventable and treatable disease with some significant
extra-pulmonary effects that
may contribute to the severity in individual patients. The pulmonary
component is characterized
by airflow limitation, which is not fully reversible. The airflow
limitation is usually
progressive and associated with an abnormal inflammatory response of the
lungs to noxious
particles or gases, such as cigarette smoke”. COPD is clinically
characterized by symptoms
like cough, sputum production, and/or dyspnea. The diagnosis is
confirmed by spirometry
and accordingly has four stages, from mild (GOLD stage I) to very severe
(GOLD stage IV). Patients with COPD typically have a decrease in both
FEV1 and a FEV1/FVC ratio of less
than 0.7. Using this ratio as cut-off point for all patients is
currently questioned as it may
underestimate COPD in the young and overestimate COPD in older
populations.
The GOLD definition has become globally accepted for the diagnosis of
COPD and some
crucial components of this definition have been incorporated by the
European Respiratory
Society (ERS) and by the American Thoracic Society (ATS).
No comments:
Post a Comment