A diagnosis of COPD (Chronic obstructive pulmonary disease) is considered in any individual showing typical symptoms with a history of exposure to risk factors such as smoking, frequent lung infections and certain industrial pollutants.
The diagnosis is confirmed by lung function tests, including spirometry. This lung function test measures the volume of air inspired or expired as a function of time reported as Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1).
In addition there are various procedures available to measure the oxygen level in the blood, including an arterial blood gas (ABG) test and an oxygen saturation test.
A bronchodilator reversibility test should be administered to exclude asthma (an airway-opener is given to the patient, in asthma patients this will lead to better lung function results, whereas, in most COPD patients the results will not improve significantly).
In general, COPD is under-diagnosed and under-treated, in many cases due to the lack of knowledge of the disease or the availability of treatment solutions.
Physicians distinguish five different stages of COPD
| Stage 0: | Risk of developing COPD. Although the lung function is still normal, symptoms such as cough and mucus production exist.
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| Stage I: | Mild COPD. The airflow is already limited (FEV1/FVC < 70% but FEV1 ≥80% predicted values), although the patient may not have noticed this yet. Symptoms such as cough and mucus production can be present.
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| Stage II: | Moderate COPD. The airflow is limited (50% ≤FEV1 < 80% predicted) and the symptoms are increasing in strength and frequency. For this reason, many patients seek medical advice at this stage.
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| Stage III: | Severe COPD. Characterized by severe airflow limitation (30%≤FEV1 < 50% predicted). The symptoms have an impact on the patient’s quality of life.
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| Stage IV: | Very severe COPD (FEV1 <30% predicted). At this stage, the limitation of airflow can be life-threatening, complications as right heart failure and respiratory failure might be present. Even if FEV1 is above 30%, COPD is considered very severe when chronic respiratory failure is diagnosed.
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