GOLD Criteria for COPD
What Do the GOLD COPD Classifications Mean? continued...
The GOLD COPD staging system can be helpful toward these goals. But the system is not accurate or precise enough to predict symptoms or life expectancy in individual people living with COPD.
One problem is that the GOLD COPD classifications only consider a person's degree of airflow obstruction. On average, people with severe airflow obstruction from COPD do have worse symptoms and a shorter life expectancy than people with mild obstruction. However, many other factors beside airflow obstruction influence breathing symptoms and life expectancy, such as:
- Overweight and obesity
- Smoking status
- Other medical conditions, especially heart disease
- Physical fitness and exercise habits
For these reasons, GOLD COPD staging can be inaccurate when applied to individual people. For instance, a person with "severe" COPD according to GOLD criteria who exercises daily may have fewer symptoms and outlive a person with "mild" COPD in poor physical shape.
Other COPD staging criteria have been suggested, which consider such factors as the ability to exercise, body weight, and the degree of breathlessness. One such system, the BODE index, seems to predict life expectancy somewhat better than GOLD COPD staging. However, no staging system can predict what an individual person's symptoms or life expectancy with COPD will be.
What Are the GOLD COPD Guidelines?
GOLD has issued guidelines to help doctors treat people with COPD. Some of the major GOLD COPD guidelines include:
- Doctors should suspect COPD in anyone with shortness of breath, chronic cough, and/or a history of cigarette smoking.
- Doctors should recommend pulmonary function testing to people who meet these COPD criteria.
- Quitting smoking, and continued smoking abstinence are absolutely essential for anyone with COPD.
- Inhaled corticosteroids may be recommended for people with severe COPD with frequent exacerbation episodes. Oxygen may be needed for those with very severe COPD.
- Treatments should mainly consist of bronchodilators: inhaled medication that improves breathing.
- Treatments should be individualized. Each person should use a drug or combination of drugs that work for him or her.
The GOLD COPD guidelines also recommend that all people with COPD receive an influenza vaccine every year.