FEV1 감소 중증도가 COPD 악화와 역의 관계가 있을지라도 FEV1 단독으로 각 개인에서 급성악화를 예견하지 못합니다. 이와 같은 이유로 FEV1은 더 이상 ABCD 평가 카테고리에 포함되지 않습니다.
Multidimensional assessment of COPD
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GOLD "ABCD" grading: Assessment of symptoms and risk of exacerbations for initiation of COPD therapy |
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Assess exacerbation risk: Exacerbations/Hospitalizations |
Assess symptoms |
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mMRC* 0 to 1; CAT <10¶ |
mMRC ≥2; CAT ≥10 |
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0 or 1 exacerbations without hospitalization |
A |
B |
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≥2 exacerbations or ≥1 hospitalization |
C |
D |
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GOLD: Severity of airflow limitation (based on postbronchodilator FEV1) |
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Stage |
Severity |
FEV1 (percent predicted) |
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In patients with FEV1/FVC <0.7:Δ |
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GOLD 1 |
Mild |
≥80 |
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GOLD 2 |
Moderate |
50 to 79 |
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GOLD 3 |
Severe |
30 to 49 |
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GOLD 4 |
Very severe |
<30 |
COPD: chronic obstructive pulmonary disease; GOLD: Global Initiative for Chronic Obstructive Lung Disease; mMRC: modified Medical Research Council dyspnea scale; CAT: COPD Assessment Test; FEV1: forced expiratory volume in one second; FVC: forced vital capacity.
* mMRC dyspnea scale: Refer to UpToDate graphic.
¶ http://www.catestonline.org.
Δ The GOLD guidelines (www.goldcopd.org) prefer the threshold of <0.7 to the alternative of the fifth percentile lower limit of normal (LLN) for FEV1/FVC.
REF. UpToDate 2020.05.27
