Chronic Obstructive Pulmonary Disease (COPD)
(Last Updated - 5/17/2007)

GOLD Staging System:

Stage:            Classification:            Characteristics:
   0                   At Risk                   -Normal Spirometry
                                                     -Chronic symptoms (cough and/or sputum)

   1                   Mild                       -FEV1 / FVC < 70%
                                                      -FEV1 >= 80% predicted
                                                      -W/ or w/out chronic symptoms (cough and/or sputum)

   2                   Moderate                 -FEV1 / FVC < 70%
                                                      -FEV1 >= 50% but < 80% predicted
                                                      -W/ or w/out chronic symptoms (cough and/or sputum)

   3                   Severe                     -FEV1 / FVC < 70%
                                                      -FEV1 >= 30% but < 50% predicted
                                                      -W/ or w/out chronic symptoms (cough and/or sputum)

   4                   End-Stage               -FEV1 / FVC < 70%
                        (Very Severe)           -FEV1 < 30% predicted OR FEV1 < 50% predicted w/ resp. failure
                                                           -Resp. Failure:
                                                                -PaO2 < 60mm Hg w/ or w/out PaCO2 > 50mm Hg while breathing air @ sea level

-COPD Exacerbation Steroid Taper Regimen (NEJM - 6/24/1999 (340, #25 - p. 1941-1947):
     1) IV Solucortef 125 mg Q6H x 72 hrs then
     2) Prednisone 60 PO QDay x4 days then
     3) 40 PO QDay x4 days then
     4) 20 PO QDay x4 days then
     5) Off

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References:

1) NEJM - 6/24/1999 (340, #25 - p. 1941-1947)