Global assessment of the COPD patient: time to look beyond FEV1?

Respir Med. 2009 May;103(5):650-60. doi: 10.1016/j.rmed.2009.01.001. Epub 2009 Jan 24.

Abstract

COPD is a diverse disease entity with multiple dimensions that uniquely define the patient's performance, morbidity and mortality. FEV(1) is both the traditional metric used to define the progression of COPD as well as the strongest spirometric predictor of mortality in COPD patients. However, besides pulmonary functional abnormalities, COPD is also associated with significant systemic effects. Therefore, the global assessment of an affected patient should include different aspects of the consequences of this disorder, beyond the "gold-standard" assessment of airflow limitation. Quantification of the patient's dyspnea, body composition as expressed by BMI, simple measures of exercise capacity such as the 6MWD, assessment of comorbidities and identification of characteristics related to different phenotypes are features that may lead to more optimal management of such patients.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Body Mass Index
  • Comorbidity
  • Disease Progression
  • Dyspnea / complications
  • Exercise Tolerance / physiology
  • Forced Expiratory Volume
  • Humans
  • Phenotype
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Pulmonary Disease, Chronic Obstructive* / therapy
  • Quality of Life
  • Respiratory Function Tests
  • Severity of Illness Index

Substances

  • Biomarkers