Lovego Weekly report-Assessment of COPD

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Weekly report

Assessment of COPD

We had introduced the FEV1(GOLD) and the COPD Assessment Test (CAT) in last weekly report.Now let’s discuss the Assessment of COPD

As we know,the severity of the airflow obstruction can be assessed is by looking at the level of the FEV1.Just as we discussed before. The amount of airway narrowing can be classified as follows(FEV/FVC< 70 %):

GOLD 1: Mild FEV1 > 80% predicted

GOLD 2: Moderate 50% < FEV1 < 80% predicted

GOLD 3: Severe 30% < FEV1 < 50% predicted

GOLD 4: Very Severe FEV1 < 30% predicted

And It is a common sense that COPD does not just affect the lungs but also can affect us in other ways. For example, patients with more severe disease can lose muscle mass and lose weight, and may also develop anxiety or depression. 

A number of factors determine how severe your COPD is, one is the level of airflow obstruction (FEV1). The other important factors to consider include the number of exacerbations (flare ups) and the level of breathlessness. This can usually be graded using the MRC (medical research council dyspnoea (breathless) scale which is recommended for the assessment of disability of COPD depending on the amount of exertion that it takes to make you breathless: 

MRC score 1-short of breath on strenuous exertion

MRC Score 2-short of breath on hurrying on a level surface or walking up a slight hill

MRC Score 3-walking slower than people of the same age on the level, or stops for breath while walking at own pace on the level 

MRC Score 4- stops for breath after walking about 100 yards

MRC Score 5- too short of breath to leave the house or short of breath when dressing or undressing

So,to the New Assessment Model – ABCD

Four steps to go ahead
1. Assess symptoms,(using CAT and MRC to assess )

        2.Assess degree of airflow limitation using spirometry [Gold(FEV1)]             3.Assess risk of exacerbations(use history of exacerbations and spirometry:                  Two or more exacerbations within the last year or an FEV1 < 50 % of predicted value are indicators             of high risk)
           4.Assess comorbidities

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