Table 3.

Summary of Chronic Obstructive Pulmonary Disease

Epidemiology	Incidence of 9.2/1,000 person-years in patients ≥55 years old
	Increases with age through 75–79 years old
	Higher incidence in men
	Prevalence of at least 10% in patients ≥65 years old in the United States
	Prevalence of 5%–16% in patients ≥40 years old internationally
Clinical presentation and evaluation	Cigarette smoking history
	Occupational exposures
	Cough, wheeze, dyspnea
	Chronic sputum production
	Pulmonary function tests if able
	May be better to avoid using fixed ratio of FEV1/FVC to minimize over diagnosis
Risk factors	Age
	Alpha-1 antitrypsin deficiency
	Tobacco smoke: current, >20 pack-year history
	Biomass smoke exposure, occupational exposure
Treatment	Inhaled beta-agonists*
	Inhaled anticholinergics*
	Inhaled and systemic corticosteroids*
	Theophylline
	Roflumilast
	Pulmonary rehabilitation
	Antibiotics for exacerbations
Determinants of outcome and health-related quality of life	FEV1(positive association)
	6-Minute walk distance (positive association)
	Comorbidities (negative association)
	Severity of airway obstruction (negative association)
	Ability to perform activities of daily living
	Emotional state

Notes: FEV1 = forced expiratory volume in 1 s; FVC = forced vital capacity

^*Assure proper inhaler technique.