Last edited 12/2018
- if in a middle-aged patient the FEV1 is 1 litre below the expected value then the patient is very likely to become disabled by airways obstruction unless they stop smoking.
- if a patient stops smoking then the rate of deterioration of FEV1 reverts back to that which normally would occur with advancing age, thus improving prognosis.
- there is a mortality rate of 10% per year once the FEV1 approaches 1 litre.
- prognosis is better if the predominant pathology is that of mucus hypersecretion than those patients in which airways obstruction predominates.
- if there is the development of cor pulmonale and pulmonary hypertension then the 5 year survival is about 30%.
- weight loss is associated with considerably increased morbidity and mortality.
NICE guidance suggest that a
- disability in COPD can be poorly reflected in the FEV1. A more comprehensive assessment of severity includes the degree of airflow obstruction and disability, the frequency of exacerbations and the following known prognostic factors:
- breathlessness (MRC scale)
- health status
- exercise capacity (for example, 6-minute walk test)
- partial pressure of oxygen in arterial blood (PaO2)
- cor pulmonale (1)