GOLD classification
The Global Initiative for Obstructive Lung Disease (GOLD) classifies the lung disease COPD into four degrees of severity. The condition is determined by spirometry using certain lung function parameters, the one-second capacity (FEV1) and the Tiffneau index. Additionally, the severity of symptoms and the number of previous acute attacks (exacerbations) are important for the classification into the stages according to GOLD.
Certain questionnaires are used as an aid in recording the severity of symptoms. These are the mMRC dyspnoea scale (Modified Medical Research Council), which reflects the severity of shortness of breath and its influence on everyday activities, and the CAT (COPD Assessment Test). The CAT is discussed in detail below. The aim of the GOLD classification is to standardize the treatment of COPD worldwide and to adapt the steps taken therapeutically to the stage of the disease of the person affected.
CAT score
The COPD Assessment Test (CAT) contains eight questions about the symptoms and their severity, which must be answered by the patient. The questions relate to the frequency of coughing, phlegm, the presence of an enfeeling in the chest, physical resilience, everyday competence, sleep quality and the patient’s well-being. For each question, a score of zero to five points can be awarded, depending on the severity of the symptoms. The points are then added together in the evaluation. This results in a possible score of minimum 0 and maximum 40 points.
How do the stages influence life expectancy?
Life expectancy in chronic obstructive pulmonary disease (COPD) depends on many different individual factors. In addition to the severity or stage of COPD, these include the patient’s age and the results of lung function measurements. In addition, the life expectancy of the patient reflects how consistently the therapy plan is adhered to at all times during the disease.
In general it can be said that the lifespan of a person suffering from COPD is significantly reduced. As far as life expectancy in COPD is concerned, however, it can generally be said that the progression of the disease is difficult to predict, and in individual cases this can deviate greatly from the statistically expected course. This is due to the fact that the course of the disease can be influenced by many different factors.
However, it can be stated that an increasing loss of lung function has a negative effect on the prognosis and life expectancy. The FEV1 value (the one-second capacity) determines the classification of severity. The lower the FEV1 value, that is, the more it deviates from the target value, the higher the stage of COPD and the lower the life expectancy.
Degrees of severe disability by stage
Depending on the stage of the disease, COPD can lead to severe impairments in everyday life and need for help. Those COPD patients who are considered severely disabled according to the German Social Security Code or who have a degree of disability (GdB) of at least 50 percent can apply for a disability card. As a rule, this concerns patients from COPD stage III onwards, with the office for social affairs determining the degree of disability.
A severely handicapped pass leads to tax relief, brings with it special protection against dismissal and some special rights in the profession. However, COPD patients are only entitled to a disabled parking permit in exceptional cases.
