Skip to main content
SpringerLink
Log in

Definition of Chronic Obstructive Pulmonary Disease (COPD): Is the Latest GOLD Classification of Severity Still Valid?

  • Chapter
  • First Online:
Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response evoked by the presence of noxious particles or gases in the airways. The progression of airflow limitation has a tremendous impact on disease severity and overall prognosis. However, other factors, such as symptoms, exacerbations, or comorbidities, also have a considerable impact on individual COPD patients. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Scientific Committee launched a joint project between the World Health Organization and the National Heart, Lung, and Blood Institute. The initial report of the GOLD guideline for COPD was published in 2001. Since then, the GOLD Scientific Committee has kept the GOLD guideline updated by revising it on the basis of the latest scientific evidence. Although the GOLD classification was initially based on the severity of airflow limitation, the classification of symptoms, breathlessness, and risk of exacerbations as well as spirometry results was recently included because of the accumulated scientific evidence. In this chapter, we will define COPD and discuss the latest GOLD classification.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fukuchi Y, Nishimura M, Ichinose M, et al. COPD in Japan: the Nippon COPD Epidemiology study. Respirology. 2004;9(4):458–65.

    Article  PubMed  Google Scholar 

  2. Tsukamura M. Chronic obstructive lung disease. A statement of the committee on therapy. Am Rev Respir Dis. 1965;92:513–8.

    CAS  PubMed  Google Scholar 

  3. Burrows B, Fletcher CM, Heard BE, et al. The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. Lancet. 1966;1(7442):830–5.

    Article  CAS  PubMed  Google Scholar 

  4. Filley GF, Beckwitt HJ, Reeves JT, et al. Chronic obstructive bronchopulmonary disease. II. Oxygen transport in two clinical types. Am J Med. 1968;44(1):26–38.

    Article  CAS  PubMed  Google Scholar 

  5. Orie NG, Sluiter HJ, De Vries K, et al. The host factor in bronchitis. In: Orie NG, Sluiter HJ, editors. Bronchitis. Assen: Royal Van Gorcum; 1961. p. 43–59.

    Google Scholar 

  6. American Thoracic Society. A statement of the committee on therapy; Chronic obstructive lung disease. Am Rev Respir Dis. 1965;92:513–8.

    Google Scholar 

  7. Hogg JC, Macklem PT, Thurlbeck WM. Site and nature of airway obstruction in chronic obstructive lung disease. N Engl J Med. 1968;278(25):1355–60.

    Article  CAS  PubMed  Google Scholar 

  8. Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363(12):1128–38.

    Article  CAS  PubMed  Google Scholar 

  9. Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648–54.

    Article  CAS  PubMed  Google Scholar 

  10. Nishimura K, Izumi T, Tsukino M, et al. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. Chest. 2002;121(5):1434–40.

    Article  PubMed  Google Scholar 

  11. Jones PW, Quirk FH, Baveystock CM. The St George’s Respiratory Questionnaire. Respir Med. 1991;85:Suppl. B:25–31.

    Google Scholar 

  12. Larson JL, Covey MK, Berry JK, et al. Reliability and validity of the Chronic Respiratory Disease Questionnaire. Am Rev Respir Dis. 1993;147:A530.

    Google Scholar 

  13. van der Molen T, Willemse BW, Schokker S, et al. Development, validity and responsiveness of the Clinical COPD Questionnaire. Health Qual Life Outcomes. 2003;1:13.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest. 2000;117:398S–401.

    Article  CAS  PubMed  Google Scholar 

  15. Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003;41:46s–53.

    Article  CAS  PubMed  Google Scholar 

  16. Celli BR, Barnes PJ. Exacerbations of chronic obstructive pulmonary disease. Eur Respir J. 2007;29:1224–38.

    Article  CAS  PubMed  Google Scholar 

  17. Seemungal TA, Donaldson GC, Bhowmik A, et al. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161:1608–13.

    Article  CAS  PubMed  Google Scholar 

  18. Kessler R, Stahl E, Vogelmeier C, et al. Patient understanding, detection, and experience of COPD exacerbations: an observational, interview-based study. Chest. 2006;130:133–42.

    Article  PubMed  Google Scholar 

  19. Donaldson GC, Seemungal TA, Bhowmik A, et al. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002;57:847–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Connors Jr AF, Dawson NV, Thomas C, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to understand prognoses and preferences for outcomes and risks of treatments). Am J Respir Crit Care Med. 1996;154:959–67.

    Article  PubMed  Google Scholar 

  21. Gunen H, Hacievliyagil SS, Kosar F, et al. Factors affecting survival of hospitalized patients with COPD. Eur Respir J. 2005;26:234–41.

    Article  CAS  PubMed  Google Scholar 

  22. Agusti A, Calverley PM, Celli B, et al. Characterizations of COPD heterogeneity in the ECLIPSE cohort. Respir Res. 2010;11:122.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Decramer M, Celli B, Kesten S, et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLlFT): a prespecified subgroup analysis of a randomized controlled trial. Lancet. 2009;374:1171–8.

    Article  CAS  PubMed  Google Scholar 

  24. Jenkins CR, Jones PW, Calverley PM, et al. Efficacy of salmeterol/fluticasone propionate by GOLD stage of chronic obstructive pulmonary disease: analysis from the randomized, placebo-controlled TORCH study. Respir Res. 2009;10:59.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lange P, Marott JL, Vestbo J, et al. Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification: a study of the general population. Am J Respir Crit Care Med. 2012;186(10):975–81.

    Article  PubMed  Google Scholar 

  26. Karloh M, Mayer AF, Maurici R, et al. The COPD Assessment Test: what do we know so far?: a systematic review and meta-analysis about clinical outcomes prediction and classification of patients into GOLD stages. Chest. 2016;149(2):413–25.

    Article  PubMed  Google Scholar 

  27. Worth H, Buhl R, Criée CP, et al. The ‘real-life’ COPD patient in Germany: the DACCORD study. Respir Med. 2016;111:64–71.

    Article  PubMed  Google Scholar 

  28. Mannino DM, Thorn D, Swensen A, et al. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J. 2008;32(4):962–9.

    Article  CAS  PubMed  Google Scholar 

  29. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html.

  30. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:1005–12.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Kazuhisa Asai & Kazuto Hirata

Authors
  1. Kazuhisa Asai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuto Hirata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuto Hirata .

Editor information

Editors and Affiliations

  1. Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan

    Hiroyuki Nakamura

  2. Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan

    Kazutetsu Aoshiba

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Science+Business Media Singapore

About this chapter

Cite this chapter

Asai, K., Hirata, K. (2017). Definition of Chronic Obstructive Pulmonary Disease (COPD): Is the Latest GOLD Classification of Severity Still Valid?. In: Nakamura, H., Aoshiba, K. (eds) Chronic Obstructive Pulmonary Disease. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-10-0839-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-0839-9_1

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-0838-2

  • Online ISBN: 978-981-10-0839-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation