The Global Initiative for Chronic Obstructive Lung Disease (GOLD) graded severity of chronic obstructive pulmonary disease (COPD), based primarily on spirometric findings.
Parameters:
(1) clinical symptoms (cough, sputum production, dyspnea)
(2) measured FEV(1) in liters
(3) predicted FEV(1) in liters
(4) measured FVC in liters
(5) signs of organ failure (respiratory or right heart)
where:
• Respiratory failure consists of a PaO2 < 60 mm Hg (< 8.0 kPa) while breathing room air at sea level with or without PaCO2 > 50 mm Hg (> 6.7 kPa).
|
Clinical Symptoms |
ratio of measured FEV(1) to FVC |
ratio of measured to predicted FEV(1) |
Stage of COPD (2001) |
Stage of COPD (2003) |
|
chronic symptoms |
normal |
normal |
0 (at risk) |
0 (at risk) |
|
with or without |
< 70% |
>= 80% |
I (mild) |
I (mild) |
|
with or without |
< 70% |
50 - 79% |
IIA (moderate) |
II (moderate) |
|
with or without |
< 70% |
30 - 49% |
IIB (moderate) |
III (severe) |
|
with or without |
< 70% |
< 30% |
III (severe) |
IV (very severe) |
|
organ failure |
< 70% |
NA |
III (severe) |
IV (very severe) |
If references values for FEV(1) are not available, the equations of Crapo et al (1981) can be used to calculate a predicted FEV(1) value for the patient.
predicted FEV(1) in liters for males =
= (0.0414 * (height in cm)) - (0.0244 * (age in years)) - 2.190
predicted FEV(1) in liters females =
= (0.0342 * (height in cm)) - (0.0255 * (age in years)) - 1.578
Purpose: To grade the severity of chronic obstructive pulmonary disease (COPD) based on clinical and spirometric findings using the GOLD criteria.
Specialty: Pulmonology
Objective: criteria for diagnosis, severity, prognosis, stage
ICD-10: J44,
