A 52-year-old smoker with COPD has FEV1/FVC 0.61 (post-BD), FEV1 42% predicted, 3 exacerbations in the past year (2 requiring hospitalisation), and significant dyspnoea (mMRC grade 3). According to GOLD 2023, what is his GOLD group classification?
- A GOLD group D
- B GOLD group E ✓
- C GOLD group C
- D GOLD group B
Correct answer: B. GOLD group E
Explanation
GOLD 2023 reclassified patients with ≥2 moderate exacerbations or ≥1 exacerbation requiring hospitalisation in the past year into a new high-risk 'Group E' (for Exacerbations), replacing the former A/B/C/D system. Patients in Group E, regardless of symptom burden, require LAMA + LABA ± ICS (triple therapy is indicated when blood eosinophils ≥300 cells/µL or exacerbations persist despite dual bronchodilation). This patient qualifies for Group E due to 2 hospitalisations (one hospitalisation ≥ 2 moderate exacerbations).
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.