title: The natural history of chronic obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the USA, and it remains one of the few diseases that continues to increase its numbers. The development and progression of COPD can vary dramatically between individuals. A low level of lung function remains the cornerstone of COPD diagnosis and is a key predictor of prognosis. Lung function, however, is not the only factor in determining morbidity and mortality related to COPD, with factors such as body mass index, exercise capability and comorbid disease being important predictors of poor outcomes. Exacerbations of COPD are additional important indicators of both quality of life and outcomes in COPD patients. Definitions of exacerbations can vary, ranging from an increase in symptoms to COPD-related hospitalisations and death. COPD exacerbations are more common in patients with lower levels of lung function and may lead to more rapid declines in lung function. Better understanding of the natural history of COPD may lead to better definitions of specific COPD phenotypes, better interventions and improved outcomes.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Kentucky Medical Center, 800 Rose Street, MN 614 Lexington, KY 40536, USA. dmannino@uky.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Mannino
authors.forename: G
authors.initials: G
authors.lastname: Watt
authors.forename: D
authors.initials: D
authors.lastname: Hole
authors.forename: C
authors.initials: C
authors.lastname: Gillis
authors.forename: C
authors.initials: C
authors.lastname: Hart
authors.forename: A
authors.initials: A
authors.lastname: McConnachie
authors.forename: G
authors.initials: G
authors.lastname: Davey Smith
authors.forename: M
authors.initials: M
authors.lastname: Upton
authors.forename: V
authors.initials: V
authors.lastname: Hawthorne
authors.forename: D D
authors.initials: DD
authors.lastname: Sin
authors.forename: S F P
authors.initials: SF
authors.lastname: Man
authors.forename: S
authors.initials: S
authors.lastname: Van Eeden
authors.forename: D W
authors.initials: DW
authors.lastname: Mapel
authors.forename: J
authors.initials: J
authors.lastname: Vestbo
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology