A 55-year-old smoker has post-bronchodilator FEV1/FVC of 0.62 and FEV1 44% predicted. He has had 2 exacerbations requiring hospitalisation in the last year. According to GOLD 2023 guidelines, this patient is classified as:

• A GOLD Group A (low risk, less symptoms)
• B GOLD Group B (low risk, more symptoms)
• C GOLD Grade 2, Group C
• D GOLD Group E (high exacerbation risk) ✓

Explanation

GOLD 2023 revised the classification to three groups: A (0–1 exacerbations not leading to hospitalisation), B (≥2 exacerbations or ≥1 leading to hospitalisation — moderate to severe symptoms), and E (high exacerbation risk: ≥2 exacerbations or ≥1 hospitalization). This patient with 2 hospitalizations meets Group E criteria, which drives therapeutic decisions toward dual bronchodilator or ICS-containing therapy.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.