COPD

COPD Staging

search

COPD Staging, GOLD Combined Assessment

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