Chronic Obstructive Lung Disease - Complications

Complications

COPD affects an estimated 210 million people worldwide. It is the fourth most common cause of death in the United States, responsible for more than 100,000 deaths each year, but experts predict that it will be the third leading cause of death in the world by 2030 as the population ages and people continue to smoke.

Although COPD has traditionally been considered a man's disease, an increase in women who smoke has caused COPD to skyrocket in women. Women with COPD tend to fare worse than men -- they are more likely to be hospitalized and to die from COPD. They also experience more severe symptoms, greater depression, and a worse quality of life than men.

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Women appear to be more susceptible to the effects of smoking and pollution, possibly because of hormones or other genetic differences. The good news is that women who stop smoking get their lung function back more quickly than men.

The leading cause of death from COPD is respiratory failure. However, patients with mild-to-moderate COPD also tend to develop cardiovascular disease or lung cancer. This likely occurs from inflammation, which is involved in all three diseases.

Traditionally, physicians have measured the severity of COPD by the amount of air that a person can forcibly exhale in one second (FEV1). The amount decreases as COPD gets worse. However, COPD affects other systems and body parts, which provide clues about the severity of the disease. Many physicians now use the BODE index to categorize COPD and predict its outcome. BODE stands for body mass index, degree of airflow obstruction, dyspnea (breathlessness), and exercise capacity as measured in a 6-minute walk test.

• Outlook for Patients with Emphysema. If emphysema is detected before it causes symptoms, there may be some chance of reversing it. However, permanent changes in the alveoli usually occur, even in young smokers. Patients with the inherited form of early-onset emphysema are at risk for early death, unless the disease is treated and its progression stopped or slowed. Emphysema patients who have significant, unplanned weight loss (a sign of muscle wasting) have a poorer outlook, regardless of their lung function.
• Outlook for Patients with Chronic Bronchitis. Chronic bronchitis does not cause as much lung damage as emphysema, although the airways become blocked by mucus plugs, and narrow due to inflammation. Poor air exchange leads to low oxygen levels and high carbon dioxide levels. This poor gas exchange can lead to serious, life-threatening conditions that include severe breathing difficulty and heart failure.