🌬️ GOLD Airflow-Limitation Grade (FEV1)
Grades airflow-limitation severity in COPD (GOLD 1–4) by post-bronchodilator FEV1 percent predicted, after airflow limitation is confirmed.
GOLD Airflow-Limitation Grade (FEV1)
Post-bronchodilator FEV1 % predicted (%)
When to use
First confirm post-bronchodilator FEV1/FVC < 0.70, then enter FEV1 % predicted; the tool returns the GOLD grade. Combine the grade with the symptom/exacerbation ABE assessment to guide therapy.
How it works
Prerequisite: post-bronchodilator FEV1/FVC < 0.70. GOLD 1 ≥ 80% · GOLD 2 50–79% · GOLD 3 30–49% · GOLD 4 < 30% predicted.
Key points
- The spirometric grade (1–4) and the symptom/exacerbation group (A/B/E) are separate axes — pharmacotherapy is driven mainly by the ABE group, not by the FEV1 grade alone. (original synthesis · not guideline verbatim)
- The grade is valid only after a fixed post-bronchodilator FEV1/FVC < 0.70 confirms persistent airflow limitation; pre-bronchodilator values overdiagnose.
- FEV1 correlates only modestly with symptoms and exacerbation risk, so it should not be the sole basis for treatment intensity.
References
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2024 Report.
- Agustí A, et al. GOLD 2023: Executive Summary. Eur Respir J. 2023;61(4):2300239.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.