Chronic obstructive pulmonary disease natural history


 * Philip Marcus, M.D., M.P.H. [mailto:pmarcus192@aol.com];

Overview
COPD usually gradually gets worse over time and can lead to death. The rate at which it gets worse varies between individuals. The factors that predict a poorer prognosis are:like Severe airflow obstruction (low FEV1), poor exercise capacity, shortness of breath, significantly underweight or overweight, complications like respiratory failure or cor pulmonale, continued smoking, frequent acute exacerbations. Prognosis in COPD can be estimated using the Bode Index. This scoring system uses FEV1, body-mass index, 6-minute walk distance, and the modified MRC dyspnea scale to estimate outcomes in COPD. There is no cure for COPD. However, COPD can be managed and disease progression can be mitigated. Prognosis depends largely on the timing of diagnosis.

Prognosis
A good prognosis of COPD relies on an early diagnosis and prompt treatment. Most patients will have improvement in lung function once treatment is started, however eventually signs and symptoms will worsen as COPD progresses. The median survival is about 10 years if two-thirds of expected lung function was lost by diagnosis.

Bronchitis
Acute bronchitis usually resolves in 7-10 days with no underlying lung disease. Chronic bronchitis however is dependent on early recognition and smoking cessation which improves the outcome significantly.

Emphysema
The outcome is better for patients with less damage to the lung who stop smoking immediately. Still, patients with extensive lung damage may live for many years so predicting prognosis is difficult. Death may occur from respiratory failure, pneumonia, or other complications.