Dyspnea scoring in patients with COPD

Abstract

COPD is a progressive disorder diagnosed with recognition of the symptoms and spirometry. The parameters of 
spirometry are well defined in several guidelines. According to GOLD rearranged at 2004, a post bronchodilator 
FEV1/FVC rate smaller than 70% is accepted as a diagnostic criterion for COPD. Symptoms are also important as well 
as spirometric evaluation. Indeed, these symptoms are the clinical representation of the present inflammation. Among 
symptoms, dyspnea is the most important one alarming the patient. So, classification of dyspne in a simple and 
objective way has a great value. In this study, we emphasized the presence of dyspnea in outpatients of our Chest 
Disease Department who smoked more than 10 pack/yr. Patients are classified into two groups as COPD and non
COPD group according to symptoms and spirometric evaluations. Each individual was expected to carry out a self
administered questionnaire for symptom scoring following spirometry. Presence of a rustling sound (A), preexisting 
pulmonary disease (B), and short of breath (C) were questioned and scored one by one. A, B, C and total ABC scores 
were significantly different in groups with and without COPD (p<0.001). Symptom scoring according to staging/stages 
in COPD group revealed that as COPD worsened A, B, C and total ABC scores increased. There was a significant 
difference regarding symptom scoring especially among patients without COPD and COPD patients at stage 2B and 3. 
As the patients reached higher scores, all of the spirometric parameters significantly decreased (p<0.001). It is 
important to explore and express dyspnea in the best possible way in order to avoid misdiagnosing and 
maltreatment.Examination of dyspne should not require administration of very complex questionnaires, moreover, 
with simple questionnaires it is possible to achieve reliable scoring.