respiratory

GOLD COPD Assessment (Spirometry + Symptom-Exacerbation)

Global Initiative for Obstructive Lung Disease (GOLD) 2023 COPD classification. Grades spirometric severity (GOLD 1–4) and ABCD group based on symptom burden (mMRC/CAT) and exacerbation history.

Used in: COPD

Score interpretation

GOLD 1 — Mild COPD

→ GOLD 1 (FEV₁ ≥80%): Mild COPD. SAMA or SABA PRN; LAMA ± LABA if symptomatic. Smoking cessation; annual influenza; pneumococcal vaccination. Group A (low symptoms, low exacerbations) → SAMA/SABA; Group B (high symptoms) → LAMA.

GOLD 2 — Moderate COPD

→ GOLD 2 (FEV₁ 50–79%): Moderate COPD. LAMA (tiotropium); add LABA if symptomatic. Pulmonary rehabilitation; Group E (frequent exacerbations) → LAMA + LABA ± ICS. Refer to respiratory clinic.

GOLD 3 — Severe COPD

→ GOLD 3 (FEV₁ 30–49%): Severe COPD. LAMA + LABA; add ICS if frequent exacerbations (≥2/year); azithromycin prophylaxis in exacerbation-prone patients. Home oxygen assessment (pO₂ <7.3 kPa). Palliative symptom management.

GOLD 4 — Very Severe COPD

→ GOLD 4 (FEV₁ <30%): Very severe COPD. Triple therapy (LAMA + LABA + ICS); long-term oxygen therapy if hypoxaemic; assess for lung volume reduction surgery or lung transplant; palliative care involvement; advance care planning.

Interpretation bands for the GOLD COPD. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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