We examined 40 consecutive patients with chronic obstructive pulmonary disease (COPD) admitted to our institute between April and September 1985 for acute exacerbation, when they recovered from acute exacerbation and became cooperative to undergo lung function tests. Additionally, a follow up study was also done 4 years later, for assessing whether the physical signs were indicative of poor prognosis or not, correlated with survival rate, frequency of acute exacerbations and mechanical ventilation required and application of home oxygen therapy (HOT). Four physical signs, including increased activity of strap muscle, recession of supraclavicular fossae in inspiration, loss of pump-handle movement and loss of bucket-handle movement were associated with significantly low values in all lung function parameters tested but other signs were correlated with only in 2 or 3 parameters. The long-term prognosis was poor in the patients with more physical signs (abnormality score), namely the patients, who were on HOT because of development of chronic respiratory failure had significantly more frequent episodes of acute exacerbation and mechanical ventilation, had definitely higher scores than others who did not need HOT.
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