II. See Also
III. Background: Three different staging systems
- Global Initiative for Chronic Obstructive Lung Disease (GOLD, pharma supported)
- American Thoracic Society (ATS) and European Respiratory Society (ERS)
- British Thoracic Society (BTS)
IV. Staging: GOLD Spirometric Assessment
- Post-bronchodilator FEV1 to FVC Ratio: >0.7
- Stage 0
- At risk (ATS/ERS), Symptomatic Smokers
- FEV1 >79% of predicted
- Stage 0
- Post-bronchodilator FEV1 to FVC Ratio <0.7
- Stage 1 - Mild (GOLD, ATS/ERS)
- FEV1 >79% of predicted
- Exacerbations per year: 0-1
- Gold Risk Group A or B (see below)
- Stage 2 - Moderate (GOLD, ATS/ERS), (BTS-Stage 1)
- FEV1 50-80% of predicted
- Exacerbations per year: 0-1
- Gold Risk Group A or B (see below)
- Stage 3 - Severe (GOLD, ATS/ERS), (BTS-Stage 2)
- FEV1 30-49% of predicted
- Exacerbations per year: 2 or more
- Gold Risk Group C or D (see below)
- Stage 4 - Very Severe (GOLD, ATS/ERS), (BTS-Stage 3)
- FEV1 <30% of predicted
- Exacerbations per year: 2 or more
- Gold Risk Group C or D (see below)
- Stage 1 - Mild (GOLD, ATS/ERS)
V. Grading: GOLD Combined Assessment (Spirometry and symptom score)
- Risk Group A (low risk, fewer symptoms)
- Gold Stage 1 or 2
- Exacerbations per year: 0-1
- mMRC Score: 0 or 1
- COPD Assessment Test: <10
- Risk Group B (low risk, more symptoms)
- Gold Stage 1 or 2
- Exacerbations per year: 0-1
- mMRC Score: 2 or more
- COPD Assessment Test: 10 or more
- Risk Group C (high risk, fewer symptoms)
- Gold Stage 3 or 4
- Exacerbations per year: 2 or more
- mMRC Score: 0 or 1
- COPD Assessment Test: <10
- Risk Group D (high risk, more symptoms)
- Gold Stage 3 or 4
- Exacerbations per year: 2 or more
- mMRC Score: 2 or more
- COPD Assessment Test: 10 or more
VI. Resources
- GOLD Global Strategy