Emphysema, together with chronic bronchitis, is classified as chronic obstructive pulmonary disease. This is progressive disease which affects terminal parts of the lungs called alveoli. The disease features with shortness of breath and increased susceptibility to infections. In terminal stage of emphysema patients are bed ridden and require administration of oxygen and numerous medications. There are a few staging systems for emphysema. They can divide people into several groups and predict the outcome according to certain characteristics of the disease.
Before the staging the patients undergo pulmonary function testing. This test is essential in follow-up of the lung capacity. The results of pulmonary function testing determine the prognosis in majority of patients suffering from emphysema. In emphysema destruction of alveolar walls leads to accumulation of the air within lungs and the patient has difficulties with exhaling.
The GOLD Emphysema Staging System
This staging system was created by the Global Initiative for Chronic Obstructive Lung Disease hence the name of the staging system. The most significant factor in GOLD staging system is the quantity of air which is forcefully exhaled in the first second of pulmonary function testing. This amount of air is known as forced expiratory volume or FEV1.
According to GOLD staging system there are four stages of emphysema. The first stage includes mild forms of the disease in which FEV1 is either 80% of normal values or above this level. In the second stage, which is also known as moderate stage of the disease, FEV1 ranges from 50% to 80% of normal values. The third stage or severe form of emphysema features with FEV1 of between 30% and 50% of normal values. And finally, the fourth stage of emphysema features with less than 30% of normal FEV1. The last stage is actually a very severe form of the disease. The higher the stage of the disease is, the worse is the prognosis for patients.
The BODE Emphysema Staging System
This is one more staging system for emphysema. In this case, the factor that is used in staging is not related to FEV1. Namely, BODE emphysema staging system is based on the impact of the disease on numerous areas of life. B in BODE staging system stands for body mass index, which is related to weight and height of the patients. O stands for obstruction. Respiratory obstruction can be mild or severe where patients require additional supply with oxygen. Obstruction is easily measured by pulmonary function tests. D stands for dyspnea which is shortness of breath. And finally, E stands for exercise capacity. Exercise capacity refers to the distance that can be overcome in six minutes.
Unfortunately, no matter how these staging systems can be helpful they simply cannot predict the actual outcome in every patient. The prognosis is after all individual and unique.