Jo Yong Suk
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2022 Oct;85(4):289-301. doi: 10.4046/trd.2022.0074. Epub 2022 Jul 13.
Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation characterized by fixed airflow limitation and chronic respiratory symptoms, such as cough, sputum, and dyspnea. COPD is a progressive disease characterized by a decline in lung function. During the natural course of the disease, acute deterioration of symptoms leading to hospital visits can occur and influence further disease progression and subsequent exacerbation. Moreover, COPD is not only restricted to pulmonary manifestations but can present with other systemic diseases as comorbidities or systemic manifestations, including lung cancer, cardiovascular disease, pulmonary hypertension, sarcopenia, and metabolic abnormalities. These pulmonary and extrapulmonary conditions lead to the aggravation of dyspnea, physical inactivity, decreased exercise capacity, functional decline, reduced quality of life, and increased mortality. In addition, pneumonia, which is attributed to both COPD itself and an adverse effect of treatment (especially the use of inhaled and/or systemic steroids), can occur and lead to further deterioration in the prognosis of COPD. This review summarizes the long-term outcomes of patients with COPD. In addition, recent studies on the prediction of adverse outcomes are summarized in the last part of the review.
慢性阻塞性肺疾病（COPD）是一种以持续性气流受限和慢性呼吸道症状（如咳嗽、咳痰和呼吸困难）为特征的慢性气道炎症。COPD是一种以肺功能下降为特征的进行性疾病。在疾病的自然进程中，症状的急性恶化可导致患者就医，并影响疾病的进一步进展及随后的病情加重。此外，COPD不仅局限于肺部表现，还可伴有其他全身性疾病作为合并症或全身表现，包括肺癌、心血管疾病、肺动脉高压、肌肉减少症和代谢异常。这些肺部和肺外情况会导致呼吸困难加重、身体活动减少、运动能力下降、功能衰退、生活质量降低和死亡率增加。此外，肺炎可因COPD本身以及治疗的不良反应（尤其是吸入和/或全身使用类固醇）而发生，并导致COPD预后进一步恶化。本综述总结了COPD患者的长期预后。此外，综述的最后部分总结了近期关于不良预后预测的研究。
