GOLD COPD Classification
GOLD 2023 ABE assessment: groups COPD by exacerbation history and symptom burden (CAT/mMRC) to guide initial therapy. The spirometric grade (GOLD 1–4) and blood eosinophil count are recorded alongside; they do not change the group.
Score interpretation
GOLD Group A: 0–1 moderate exacerbations (none leading to hospital admission) and low symptom burden (mMRC 0–1, CAT < 10).
→ Initial therapy: SABA or SAMA PRN. If symptoms persist: LAMA or LABA. Annual spirometry. Smoking cessation. Pulmonary rehabilitation if deconditioning.
GOLD Group B: 0–1 moderate exacerbations (none leading to hospital admission) and high symptom burden (mMRC ≥ 2 or CAT ≥ 10).
→ Initial therapy: LAMA + LABA dual bronchodilator. Pulmonary rehabilitation. Annual influenza + pneumococcal vaccination.
GOLD Group E (formerly C/D): ≥ 2 moderate exacerbations or ≥ 1 leading to hospitalisation in the past year. Significant morbidity and mortality risk.
→ Initial therapy: LAMA + LABA; consider LAMA + LABA + ICS if blood eosinophils ≥ 300 cells/µL. Pulmonary rehabilitation. Assess for long-term oxygen therapy (LTOT) if SpO₂ ≤ 88% at rest.
Interpretation bands for the GOLD COPD. Apply clinical judgement and local guidance.
References
- GOLD 2023 Global Strategy for Prevention, Diagnosis and Management of COPD. Global Initiative for Chronic Obstructive Lung Disease.
- NICE NG115. Chronic obstructive pulmonary disease in over 16s. 2019.
Related
Curated clinical cross-links plus same-class fallbacks.
- Fluticasone Furoate / Umeclidinium / Vilanterol · Triple Therapy ICS/LAMA/LABA — COPD
- Beclometasone / Formoterol / Glycopyrronium · Triple Therapy ICS/LABA/LAMA — COPD
- Indacaterol / Glycopyrronium · LABA/LAMA Dual Bronchodilator — COPD
- Azithromycin (COPD Exacerbation Prophylaxis) · Macrolide antibiotic (anti-inflammatory / prophylactic)
- Doxycycline (COPD Exacerbation / CAP) · Oral tetracycline antibiotic
- Co-amoxiclav 625mg (COPD Exacerbation / CAP) · Beta-lactam / Beta-lactamase inhibitor combination antibiotic
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.