Diagnostiek van COPD bij hoestklachten

Broekhuizen BDL, Sachs APE, Hoes AW, Verheij JM, Moons KGM. Cough and the diagnosis of COPD. Huisarts Wet 2012;55(1):30-3.

Guidelines recommend the early diagnosis of COPD in patients presenting with respiratory symptoms. However, it is difficult to diagnose COPD in an early, mild stage, and the independent diagnostic value of symptoms, signs, and test results is not known. In a study conducted between 2006 and 2009, we investigated 400 middle-aged or older patients who had consulted their general practitioner for persistent cough and in whom COPD had not yet been diagnosed. They underwent extensive diagnostic screening for COPD, and a consensus panel used available information to diagnose COPD or other disorders. A substantial proportion of the patients were diagnosed with COPD (29%), especially in an early, mild, stage, and some had asthma (7%). A brief medical history and physical examination were helpful in determining the risk of COPD. The level of C-reactive protein and a 14-day trial with oral prednisolone were not of additional diagnostic value. Office spirometry provided substantial diagnostic information additional to that provided by the patient history and physical examination. Little is known about the effect of treatment of mild COPD, but the undoubted beneficial effect of stopping smoking on the prognosis is an argument for the early detection and diagnosis of COPD.