12.07.2024
Despite it being a common and treatable disease, Chronic Obstructive
Pulmonary Disease (COPD) tends to go undiagnosed or misdiagnosed,
which then leads to inadequate treatment. It truly makes a difference
to recognize COPD's links to factors beyond smoking, its potential
early onset, and forerunner conditions in terms of enabling prevention
and early intervention.
Today, we would like to inform you about the GOLD (Global Initiative
for Chronic Obstructive Lung Disease) stages in COPD and discuss what
these stages mean for the diagnosis and treatment. The categorization
made within the GOLD stages is based on the severity of the disease,
that is decided in terms of the level of airflow obstruction. The
stages that are going to be to be briefly explained in the following
are defined by the post-bronchodilator FEV1/FVC (forced expiratory
volume in one second/forced vital capacity) ratio.
In the initial stage of COPD, namely GOLD 1, the functioning of the
lung deviates by 0–20 percent from the target (norm) value. In line
with these numbers, the difficulty in breathing is usually so mild
that individuals barely notice the condition. Being one of the known
COPD symptoms, chronic cough and sputum (mucus) production may occur.
In GOLD stage 2, which is representing itself as the moderate stage of
COPD, the lung function deviates by 20–50 percent from the target
value. It is expected that the individuals may experience mild
shortness of breath during significant physical exertion at this
stage. GOLD stage 3 is characterized by severe COPD, with the lung
function deviating by 50–70 percent from the target value,
understandably leading to significant breathing difficulties and
possibly a persistent cough with thick sputum. These and other COPD
symptoms tend to become more noticeable, even with light physical
activity, such as climbing stairs.
In the end-stage, GOLD 4, one speaks of a lung function that deviates
by more than 70 percent from the target value. This is where the
patient has “severe COPD”. At this stage, the patients are not
receiving an adequate or sufficient amount of oxygen, suffering from
severe breathlessness during daily activities and sometimes even at
rest. Hence, their physical capacity is greatly limited.
It cannot be stressed how important a diagnosis of COPD in a timely
manner is, but one must also keep in mind that it involves quite a
complex approach.
First of all, one should keep in mind that COPD is not the only
chronic disease that manifests itself in breathing problems. In that
regard, eliminating other respiratory conditions, or recognizing
overlaps (such as Asthma and COPD overlap) marks one of the most
important steps in the diagnosis process. Secondly, in case a
breathing test shows a ratio between 0.60 and 0.80, it is advised to
rather double-check for accuracy. If the ratio is below 0.6, this
means that the condition is less likely to improve naturally. Although
there is currently a debate about whether to use a fixed ratio or
another measure called LLN (Lower Limit of Normal) for diagnosis, many
healthcare workers seem to prefer the simplicity of the fixed ratio.
Lastly, not everyone needs to be screened for COPD, but for those with
symptoms or risks, a breathing test can be a valuable tool for early
detection. In essence, diagnosing COPD is a nuanced process that
involves considering various factors to ensure accuracy and
appropriate care, in line with the indications of the GOLD stages.
Having gone over the meaning of the GOLD stages and made a few remarks
on the importance of, and challenges in the diagnosis of COPD, we
would now like to dedicate the last part to something that we think is
going to interest you: The Breathment Therapy App that revolutionizes
COPD therapy and management. Providing a remote way of COPD
physiotherapy, Breathment aims to be a key in improving your quality
of life, bringing the exercises, physiotherapists and educational
content, all in your hands. Book an appointment with us now to learn
how Breathment makes your life with COPD easier.
