GOLD Staging System for Chronic Obstructive Lung Disease (COPD) Severity

The European Respiratory Society (ERS) diagnostic criteria for COPD include the following symptoms: coughing, sputum production and/or dyspnoea, as well as a history of exposure to risk factors for COPD. The diagnosis is confirmed by a post-bronchodilator FEV1/FVC < 0.7 in spirometry, as sign of the airflow limitation that is not fully reversible.

GOLD Staging System for COPD Severity

Stage

Description

Findings (based on postbronchodilator FEV1)

0

At risk

Risk factors and chronic symptoms but normal spirometry

I

Mild

FEV1/FVC ratio less than 70 percent

FEV1 at least 80 percent of predicted value

May have symptoms

II

Moderate

FEV1/FVC ratio less than 70 percent

FEV1 50 percent to less than 80 percent of predicted value

May have chronic symptoms

III

Severe

FEV1/FVC ratio less than 70 percent

FEV1 30 percent to less than 50 percent of predicted value

May have chronic symptoms

IV

Very severe

FEV1/FVC ratio less than 70 percent

FEV1 less than 30 percent of predicted value

or

FEV1 less than 50 percent of predicted value plus severe chronic symptoms

GOLD = Global Initiative for Chronic Obstructive Lung Disease; COPD = chronic obstructive pulmonary disease; FEV1 = forced expiratory volume in one second; FVC = forced vital capacity.

 

 

References:

  1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2005. Accessed online April 01, 2006. [Summary]

  2. Dewar M, Curry RW Jr. Chronic obstructive pulmonary disease: diagnostic considerations. Am Fam Physician. 2006 Feb 15;73(4):669-76. [Medline]

  3. Pierson DJ. Clinical practice guidelines for chronic obstructive pulmonary disease: a review and comparison of current resources. Respir Care. 2006 Mar;51(3):277-88. [Medline]

Created: April 01, 2006

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