Criteria

Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria [1]

Classification of severity of airflow limitation in COPD:

In pulmonary function testing, a post-bronchodilator FEV1/FVC ratio of <0.70 is commonly considered diagnostic for COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) system categorises airflow limitation into stages. In patients with FEV1/FVC <0.70:

  • GOLD 1 - mild: FEV1≥ 80% predicted

  • GOLD 2 - moderate: 50% ≤ FEV1 < 80% predicted

  • GOLD 3 - severe: 30% ≤ FEV1 < 50% predicted

  • GOLD 4 - very severe: FEV1 <30% predicted.

The GOLD guideline uses a combined COPD assessment approach to group patients according to symptoms and previous history of exacerbations. Symptoms are assessed using the Modified British Medical Research Council (mMRC) or COPD assessment test (CAT) scale. These can be found in the GOLD guidelines. [1]

  • Group A: low risk (0-1 exacerbation per year, not requiring hospitalisation) and fewer symptoms (mMRC 0-1 or CAT <10)

  • Group B: low risk (0-1 exacerbation per year, not requiring hospitalisation) and more symptoms (mMRC≥ 2 or CAT≥ 10)

  • Group C: high risk (≥2 exacerbations per year, or one or more requiring hospitalisation) and fewer symptoms (mMRC 0-1 or CAT <10)

  • Group D: high risk (≥2 exacerbations per year, or one or more requiring hospitalisation) and more symptoms (mMRC≥ 2 or CAT≥ 10).

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