Assessing the prognosis of patients with chronic obstructive pulmonary disease

Historically, Chronic Obstructive Pulmonary Disease (COPD) has been viewed as an irreversible disease process for which little can be done; thus the prognosis was felt to be dismal and this led to a nihilistic approach to diagnosis and management. There is now optimism surrounding the disease process of COPD as the newest definitions affirm that although it is slowly progressive, it is also a ‘partially’ reversible disease process. Accordingly, these concepts set the stage not only for establishing which currently available parameters best predict prognosis (morbidity and mortality) in COPD, but also for developing additional validated instruments to establish the prognosis of COPD and to monitor the benefits of interventional therapies: both pharmacologic and non-pharmacologic. This paper will concentrate on the current recommendations of certain COPD guidelines (those of the American Thoracic Society/European Respiratory Society and the Global Initiative for Chronic Obstructive Lung Diseases) with regar...