COPD severity assessment

Staging

  • BODE index: predict outcome and response
    • BMI
    • airflow obstruction: FEV1 percent predicted
    • dyspnea: modified British Medical Research Council (mMRC), perceived dyspnea
    • exercise capacity: 6 minute walk test. Used to approximate 4 year survival and risk for hospitalization

Disease Assessment

  • determine disease severity by
    • COPD Assessment Test (CAT)
    • Clinical COPD Questionnaire (CCQ)
    • mMRC scale
  • GOLD uses CAT or mMRC
  • BODE uses mMRC

  • high risk
    • 2 or more exacerbation in 1 year
    • FEV1 < 50% predicted
    • people hospitalized for acute exacerbation
  • a1-antitrypsin level: obtain for pts under 45 with strong family hx, without risk factor, basilar emphysema, associated liver disease, panniculitis