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Prognosis of COPD in Private Practice

OP Kapoor
A few years back the prognosis of COPD was extremely poor. In modern days it is a pleasure to see these patients living a better quality of life. This is because of advances in our treatment and better understanding of the disease. However if a family physician wants to give prognosis in a case of COPD the following points should be kept in mind.-
  1. Motivation of the patient to stop smoking. Those who do not stop smoking and even continue to smoke half or one-fourth the quantity, have bad prognosis.
  2. HRCT (High Resolution Computed Tomography) Scan should be done in every case of COPD. If multiple patchy areas of emphysema (due to destruction of alveoli) are seen, then the prognosis is bad.
  3. If the patient already has even moderate pulmonary hypertension the prognosis is very bad, and patients having severe pulmonary hypertension may not survive even for more than a year. A 2D Echo Cardiography can give you the degree of pulmonary hypertension.
  4. Finally, if reversibility of the bronchi shows a good response to steroids then prognosis is good.

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.