[COPD: diagnostic and severity assessment].

COPD: DIAGNOSTIC AND SEVERITY ASSESSMENT. Chronic obstructive pulmonary disease (COPD) is a frequent and underdiagnosed respiratory disease and a leading cause of morbidity and mortality. It should be suspected in patients aged 40 and over presenting with persistent respiratory symptoms (cough, sputum, shortness of breath, recurrent respiratory tract infections) and a history of exposure to risk factors for the disease (smoking, occupational or domestic exposure to noxious particles). Spirometry is required to confirm the diagnosis of COPD, showing persistent airflow limitation with a post-bronchodilator FEV1/FCV inférieur 0.7. COPD assessment includes: classification of airflow limitation severity with post-bronchodilator FEV1 measurement (GOLD score from 1 to 4), clinical severity assessment (intensity of dyspnea, number and severity of acute exacerbations, impaired quality of life) and evaluation of associated complications (chronic respiratory failure, hypercapnia, pulmonary hypertension). Comorbidities are frequent and should be carefully sought: lung cancer, cardiovascular diseases, metabolic syndrome, skeletal muscle dysfunction, sleep apnea syndrome, osteoporosis, anxiety and depression.