| dc.description.abstract | Abstract Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, estimated to affect about 250,000-300,000 individuals in Norway. COPD is a heterogeneous and with a dire prognosis. Traditionally a decline in the forced expiratory volume in one second (FEV1) has been considered to be the most important prognostic factor, but lately several other factors have been suggested to have a significant impact on the survival amongst COPD-patients. Objective: To present and assess the prognostic factors in COPD. Methods: A literature search was carried out in McMaster PLUS (Pyramid of evidence diagram) through helsebiblioteket.no using the term COPD and PROGNOSIS . The Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease document has been used as a pillar to easily navigate and acquire knowledge about COPD. Finally, an extensive search was done in PubMed using the thesaurus COPD, PROGNOSIS, MORTALITY and CO-MORBIDITY . Results: Several factors have been shown to significantly and in some cases independently influence the prognosis of COPD, such as gender, smoking history, dyspnea, exercise capacity, nutritional status, health-related quality of life, number of exacerbations, co-morbidities. Additionally, several multidimensional scoring systems (BODE, DOSE, COTE and more) have proven to be strong predictors of mortality. Finally, by including information about symptoms and exacerbations, the new GOLD-stratification seems to reflect the clinical course and prognosis of COPD better than the previous, which was mainly based on FEV1. Among these newly identified factors that predict the prognosis in COPD, some appear to be preventable and treatable. Conclusion: The prognosis in COPD is determined not only by the degree of airflow obstruction as measured by FEV1, but by several other single or composite factors. The identification of such factors requires a systemic evaluation of COPD patients, and seems important because it may lead to more effective interventions to prevent or treat COPD. | eng |