Combined assessment of chronic obstructive pulmonary disease according to GOLD report 2011
Iwona Grzelewska-Rzymowska, Paweł Górski
In this paper authors present a new approach to chronic obstructive pulmonary disease patients according to GOLD report 2011. Chronic obstructive pulmonary disease is a global health problem. The BOLD study proved that prevalence of it vary across countries and this disease will be the fourth leading cause of death in 2030. The main cause of chronic obstructive pulmonary disease is tobacco smoking. GOLD report 2011 recommends that a clinical diagnosis of a disease should be considered in patients presenting such symptoms as dyspnoea, cough, sputum expectoration as well as relevant exposure to risk factors with the presence of persistent airflow limitation confirmed by post-bronchodilat or FEV1/FVC < 0.70. The FEV1 is an inadequate descriptor of the impact of chronic obstructive pulmonary disease on patients. It is a complex and heterogeneous disease and that is why the validated tests are proposed – i.e. BODE index, ADO and DOSE – to examine the impact of chronic obstructive pulmonary disease on patients. GOLD report 2011 recommends the use of two validated tests: mMRC questionnaire and COPD Assessment Test (CAT). Spirometric values are classified as GOLD 1 and 2 (mild and moderate) and GOLD 3 and 4 (severe and very severe). Exacerbations of chronic obstructive pulmonary disease are based on the individual patient’s history or FEV1. Finally, the chronic obstructive pulmonary disease patients are classified to category A, B, C or D. Pharmacological treatment should be based on an individualized assessment.