COPD Staging by GOLD Guidelines

HealthCare

The new GOLD Guidelines uses the following four parameters to assess disease severity:

  • Lung function (or airflow limitation)
  • Symptoms Severity
  • Exacerbation history / risk of exacerbation
  • Comorbidities present

The old GOLD guidelines used the FEV1 to stage disease severity. The new GOLD guidelines have corrected that and encourage consideration of all of the above four parameters.

The severity of lung function impairment (i.e.airflow limitation) in COPD based on postbronchodilator FEV1

** Note that FEV1 is a measure of lung function, not overall disease severity because that must consider the severity of symptoms, the risk of exacerbations, and the presence of comorbidities.

In patients with FEV1/FVC <0.7:
GOLD 1 Mild FEV1 ≥80 percent predicted
GOLD 2 Moderate 50 percent ≤ FEV1 <80 percent predicted
GOLD 3 Severe 30 percent ≤ FEV1 <50 percent predicted
GOLD 4 Very severe FEV1 <30 percent predicted
Respiratory failure: arterial partial pressure of oxygen (PaO2) less than 60 mmHg (8 kPa) with or without arterial partial pressure of CO2 (PaCO2) greater than 50 mmHg (6.7 kPa) while breathing ambient air at sea level.

The GOLD guidelines used CAT or mMRC to assess symptom severity.

GOLD Revised combined COPD assessment (2017)

Resources:
www.goldcopd.org
http://goldcopd.org/wp-content/uploads/2016/11/wms-At-A-Glance-2017-FINAL.pdf
Calculator: http://www.thecalculator.co/health/COPD-Stages-by-GOLD-Guidelines-Calculator-908.html
https://www.uptodate.com/contents/chronic-obstructive-pulmonary-disease-definition-clinical-manifestations-diagnosis-and-staging
http://pulmccm.org/main/2013/review-articles/new-gold-guidelines-2013-better-than-the-old-gold/

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