September 2008 : Respiratory symptoms are of major importance for predicting long term clinical outcomes in subjects with stage 1 chronic obstructive lung disease (COPD)

The long-term outcomes of persons presenting with light obstructive ventilatory defect in the population is not clear. In the SAPALDIA cohort, 9 % of the participants had stage 1 COPD as measured by spirometry in 1991. Half of them also had respiratory symptoms (cough, phlegm, etc) while the other half had no symptoms (asymptomatic). In 2002, participants who had symptomatic stage 1 COPD had faster lung function decline, increased health care utilisation, and lower quality of life than the normal population. Asymptomatic stage 1 COPD did not differ from normal individuals for these outcomes. We concluded that the presence of symptoms is of major importance in stage 1 COPD. This article was published with an accompanying editorial by R. De Marco in the September issue of "Thorax". (Bridevaux PO et al, Thorax 2008, 63, 768-774)