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GOLD 2023 classification using CAT score, mMRC, and exacerbation history
Rate each item from 0-5 based on how you feel
Treated with antibiotics/steroids
ER visits or inpatient stays
Requires FEV1/FVC <0.70 for COPD diagnosis
Low symptoms, low risk
High symptoms, low risk
Exacerbator (≥2 moderate or ≥1 hospitalization)
GOLD 2023 simplified to ABE (removed C/D)
The 2023 GOLD update simplified grouping. Groups C and D were combined into Group E (Exacerbator) because both require similar treatment intensification regardless of symptom level.
CAT ≥10 indicates high symptom burden and separates Group A from B. It correlates with health status and predicts outcomes better than mMRC alone.
ICS is recommended for Group E patients with blood eosinophils ≥300 cells/μL. Avoid in patients with repeated pneumonia or eosinophils <100.
Smoking cessation is the single most effective intervention to slow FEV1 decline and improve outcomes. It should be offered at every visit.
At least annually, and after exacerbations. Assess symptoms, exacerbations, lung function, inhaler technique, and adherence. Adjust treatment accordingly.
Always confirm COPD diagnosis with post-bronchodilator FEV1/FVC <0.70. The spirometric grade (GOLD 1-4) and ABE group are separate assessments - both inform prognosis and treatment.