How can I effectively assess the severity of COPD in a patient presenting with respiratory symptoms?

To effectively assess the severity of COPD in a patient presenting with respiratory symptoms, consider the following factors:

• Measure the FEV1 to assess airflow obstruction, categorising severity according to the reduction in FEV1 as shown in table 4, with mild being FEV1 ≥80% predicted, moderate 50–79%, severe 30–49%, and very severe below 30% ¹.
• Evaluate symptom burden using tools such as the COPD Assessment Test (CAT) score, where a score >10 indicates higher symptom severity ².
• Assess exacerbation history by noting the frequency and severity of exacerbations and hospital admissions, which are linked to prognosis and treatment decisions ¹,².
• Use the MRC dyspnoea scale to grade breathlessness according to activity level, which correlates with disease severity ¹.
• Consider additional prognostic factors such as smoking status, presence of hypoxia or cor pulmonale, BMI, exercise capacity, and multimorbidity, as these influence prognosis and management ¹.

In summary, a comprehensive assessment includes spirometry (FEV1), symptom scoring (CAT, MRC), exacerbation history, and evaluation of other prognostic factors ¹,².