Definition
COPD is a chronic disease that cannot be cured, but in many cases can be avoided by avoiding risk factors. It is classically divided into 4 stages. Here stage 4 is the final stage.
The stages are classified according to various respiratory parameters and the nature of the accompanying symptoms. The revised stages according to Gold today provide for a classification into stages A to D, where D can be considered the final stage. The disease progresses slowly. A timely elimination of the most important risk factor, smoking, can prevent or significantly delay progression. In addition to the chronic symptoms in the final stage, there may be an additional acute worsening of the symptoms, which is medically referred to as exacerbation.
What are the typical symptoms of end-stage COPD?
The main symptom of end-stage COPD is severe shortness of breath. In COPD there is an increasing destruction of lung tissue, so that at a certain point there is not enough lung tissue left to ensure an adequate oxygen supply. This leads to shortness of breath.
This is progressive if the causative factors (especially cigarette smoke) are not eliminated. COPD patients in advanced stages are often noticed by the fact that they use their respiratory assistance muscles to get air better. A typical position here is the so-called coachman’s seat.
The patient sits with arms supported on the thighs. This subjectively results in a slightly better ventilation of the lungs. Lip-braking is another method that COPD patients often use unconsciously to reduce shortness of breath.
In this case, the patient exhales against the lips, which lie slightly on top of each other. While patients with COPD in the earlier stages of the disease often suffer from exercise dyspnea, i.e. shortness of breath that occurs under physical exertion, patients in the final stages of the disease are usually suffering from pronounced dyspnea at rest, i.e. shortness of breath that is already present at rest.
Another typical symptom of advanced COPD is chronic coughing. Characteristic of this cough is that it is not a dry cough but is accompanied by sputum. The cough is often strongest in the morning and is often more pronounced in the autumn and winter months than during the rest of the year.
What are the signs that the final stage has been reached?
The stages of COPD in both the new and the old classification are essentially determined by certain respiratory parameters, which are determined by pulmonary function diagnostics. COPD in stage 4 (old classification) or D (new classification) is therefore only present if certain values are present. In addition, chronic complaints occur in the final stage.
This leads to permanent shortness of breath with coughing and sputum. The risk of exacerbation is high. The constant occurrence of productive coughing as well as breathlessness at rest and a frequent occurrence of exacerbations is an indication that the final stage of COPD has been reached.