Chronic obstructive pulmonary disease (COPD) is a disease

Risk Factors and Etiopathogenesis of COPD

1. Smoking, second-hand smoking, marijuana is the #1 risk factor. PYHx > 40 (LR+12) is the strongest predictor.
2. Biomass fuel exposure
3. Advancing age
4. A1AT deficiency

Diagnosis of COPD

Spirometry: FEV1/FVC < LLN (ATS Criteria) without significant reversibility Clinical manifestations: chronic cough or sputum, dyspnea

Evaluation of COPD

Severity of Disease and Symptom Control

mMRC

mMRC Grade	Description
0
1
2
3
4

GOLD ABE Assessment Tool (2023)

Management of COPD

Non-Pharmacologic

Proven mortality benefit: Smoking cessation strategies, pulmonary rehab <4 weeks post DC, supplemental O2 for more than 15 hours daily, and NIPPV if chronically hypercapneic. Lung volume reduction surgery

No proven mortality benefit, but better QoL: Vaccination, self-management education, inhaler technique, and EOL care

Pharmacologic