Pulmonary Q&A by Dr. Schiffman

My husband has been diagnosed with Stage IV COPD, what does Stage IV indicate?

Medical Author: George Schiffman, MD
Medical Editor: Melissa Conrad Stöppler, MD


Chronic obstructive pulmonary disease (COPD), a progressive condition that obstructs air flow through the airways in and out of the lungs, has been categorized by the GOLD (Global Obstructive Lung Disease initiative) into four groups, or stages, according to the severity of the condition Stage 0, Stage I, Stage II, and Stage III.

These categories are based on an individual's lung function. In this system Stage III corresponds to severe COPD, the most advanced disease. This group includes individuals with severe airflow limitation. Another proposed staging system for COPD includes a Stage IV, which represents very severe COPD. People in this group often have evidence of respiratory failure (either low blood oxygen or high carbon dioxide levels) or clinical signs of right heart failure (such as leg swelling), that characteristically accompany respiratory failure. At this stage, quality of life is appreciably impaired. Exacerbations of the condition may occur three to four times per year and may be life-threatening.

Thank you for your question.

Last Editorial Review: 3/5/2007

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