Aspectos sistémicos y factores pronósticos

Multiple cytokines and inflammatory mediators have been implicated in the association between lung disease and extrapulmonary involvement but these theories remain purely speculative. The underlying mechanisms are probably multifactorial, complex and genetically determined. Extrapulmonary involvement, beyond airway obstruction, is based on solid scientific evidence, which in turn has generated new studies that have demonstrated how other factors influence survival in patients with COPD, independently of FEV1 and PaO2. In the next few years, these parameters should be included, based on scientific evidence, in guidelines and consensus documents for their implementation in routine clinical practice.