21. Epidemiology and prevention of chronic obstructive pulmonary disease

From greek.doctor
  • Epidemiology
    • Fourth most common cause of death worldwide
    • Leading cause of morbidity in developed countries
    • Male > female
    • 6% prevalence in US
  • Etiology
    • Smoking
      • 20 – 30 pack years gives 80-90% risk
    • Passive smoking
    • Air pollution
    • Occupational exposure to dust
    • Respiratory tract infections
    • Premature birth
    • Asthma
    • Low socioeconomic status
    • Physical inactivity
    • Alpha-1-antitrypsin deficiency
  • Diagnosed by spirometry
    • Decreased Tiffeneau index < 70%
    • <12% amelioration by bronchodilators
  • Scoring
    • GOLD – groups according to risk and symptoms
    • BODE index – prognosis
    • mMRC dyspnoea scale
  • Prevention
    • Primary
      • Health education
      • Promote smoking prevention
      • Air pollution control
    • Secondary
      • Screening for A1ATD – family members too
      • Screening of high-risk individuals
    • Tertiary
      • Stop smoking
      • Oxygen therapy
      • Pulmonary rehabilitation
      • Vaccination
        • Influenza
        • Pneumococcus
      • Exercise