12/02/2022
The Four Stages of Chronic Obstructive Pulmonary Disease (COPD)
Medically reviewed:
Stages 1-4
What is end-stage COPD?
Life expectancy?
Does prevention work?
Coping
Summary: (COPD) is a group of lung diseases that progress over time. COPD is most common in smokers and people over the age of 40. Itβs estimated that about 174 million people have COPD, and more than 3 million people around the world die from it each year.
People with COPD often have trouble breathing, a persistent cough, and shortness of breath. COPD can be subdivided into stages or grades, depending on how far it has progressed.
In its early stages, COPD is barely noticeable, but it gets worse over time unless proper treatment is sought. The earlier it is caught the better the outlook.
There are four stages of COPD. Iβll break down the symptoms expected at each stage and give potential treatment options.
What is the GOLD system for categorizing COPD severity?
(GOLD) is a program started by the National Heart, Lung, and Blood Institute and World Health Organization. Countries use its guidelines and recommendations for diagnosing and treating COPD.
The GOLD system is solely based on a patient'lung capacity measured by a spirometry test. Newest GOLD guidelines now combine spirometry results with measures of symptom severity to determine the level of risk based on their case. This information helps the service provider determine which medications could be used to help control COPD.
A spirometer test involves exhaling into a machine called a spirometer. The machine measures how hard and quickly you can exhale.
The Doctor then examines two numbers: the force vital capacity (FVC) and the force expiratory volume in one second (FEV1). The FVC is the total amount of air a patient can breathe out and FEV1 is the amount they can breathe out in one second. A ratio of the FEV1/FVC needs to be less than 0.7 for a diagnosis of COPD.
The Dr will Grade the spirometry results from grade 1 (least severe) to grade 4 most severe.
Stage 1: Early
Stage 1 COPD is considered mild. At this stage, patients may not be aware that there is anything wrong with their lung function. A Dr will assign a grade 1 COPD if the FEV1 is between 80 and 100 percent of the predicted value.
If there is score grade 1 on the spirometry test, the symptoms may be unnoticeable. If patients has symptoms, they may develop a cough and increased mucus production and may mistake the early stages of COPD for the flu.
With stage 1 COPD, the Dr may recommend bronchodilator medication to open up the airways In the lungs. These medications are usually taken through an inhaler or nebulizer. The Dr may also recommend getting flu and pneumonia vaccines to prevent illnesses that may worsen respiratory symptoms.
Changing lifestyle habits that led to the development of COPD can potentially help slow the progression of your COPD. Most people with COPD have a history of smoking. Quitting smoking and avoiding second hand smoke are two of the most important things a payient can do to improve the outlook of the disease.
Stage 2: Mild COPD is considered to be stage 2 when the FEV1 drops to 50 to 79 percent of the predicted value.
During stage 2, the symptoms worsen from stage 1. Coughing and mucus production may become more severe, and the patient may experience (SOB) shortness of breath when walking or exercising.
Typically, itβs in this stage that most persons realize that something is wrong and seek medical attention from a Dr. The patien may be given bronchodilator medication to increase airflow to the lungs. The Dr may recommend pulmonary rehabilitation, which is a program designed to increase their awareness about their condition. Itβs usually offered as a group class where they learn how to better manage their condition.
If the patient has a flare-up of symptoms a regime of steroids or oxygen may be implemented.
Stage 3: Severe!!!
By the time a patient reaches stage 3, COPD is considered severe, and the forced expiratory volume is between 30 to 50 percent of the predicted value. The patient may have trouble catching their breath doing household chores and may not be able to leave their house.
By stage 3,the patient gets more frequent flare-ups, shortness of breath and coughing will get worse. They get tired alot easier than before.
Other potential symptoms can include:
Frequent colds or sickness swelling in the ankles
chest tightness
trouble breathing and deep wheezing.
The treatment options for stage 3 COPD are similar to stage 2. The patient is more likely to need to go on oxygen at this stage.
Stage 4: Very severe Stage 4 is considered very severe. The forced expiratory volume is less than 30 percent of the normal value, and the blood oxygen levels will be low. The patient is now at risk of developing heart or lung failure.
By stage 4, frequent flare-ups can be potentially fatal. They may have trouble breathing even when theyβre resting.
Treatment options during stage 4 are similar to the previous stages. The Dr may also recommend lung surgery to improve breathing. Surgical options include:
Lung transplant,
Lung volume reduction surgery and or a
Bullectomy.
Is there an end stage to COPD?
A grade 4 score on your spirometry test is the highest gradea patient can receive. This category is also sometimes referred to as end-stage COPD.
For many people at this stage, quality of life is usually fairly low, and symptom flare-ups can be fatal.
What is the life expectancy of someone with COPD?
Having COPD lowers life expectancy. However, the percentage that it affects the life expectancy depends on many factors, such as how far the COPD has progressed and whether the patient quit smoking or changed the lifestyle habits that lead to COPD.
An older 2009 study showed that COPD led to a small reduction in lifespan for people who have never smoked, but a larger lifespan decrease for people who currently smoke or smoked in the past.
Stage 1: 1.4 years
Stage 2, 3, or 4: 5.6 years
For somebody who never smoked, the reductions are:
Stage 2: 0.7 years
Stage 3 or 4: 1.3 years
Living with COPD
No matter how far along the COPD has progressed, itβs important to change the lifestyle habits that caused the COPD in the first place. The most important thing to do is quit smoking. If the patient doesnβt quit, theyβll continue to add damage their lungs, and the COPD will progress quicker than it otherwise would.
Eating a low-carb diet filled with plenty of vegetables, healthy fats, protein, and unprocessed foods may help manage the symptoms and maintain a healthy weight. Eating foods that cause bloating, like apricots or peaches, may exacerbate breathing problems in some people.
Regular exercise may help decrease symptoms of COPD by strengthening respiratory muscles and improving cardiovascular health.
COPD used to be categorized from stage 1 to stage 4 depending on how much the lung function had decreased. Now, doctors combine the results of a lung function test with subjective measures of symptom severity to determine COPD risk.
Quitting smoking is the most important thing to do after being diagnosed with COPD to improve life expectancy and outlook.
