[Considerations on the severity classification of chronic obstructive pulmonary disease exacerbation]

Chronic obstructive pulmonary disease exacerbations (ECOPD) are critical events that worsen patients' health status, accelerate disease progression, and may lead to hospitalization or even death. However, the severity classifications of exacerbations remain imperfect. Both the traditional retrospective grading based on healthcare resource utilization and the Rome proposal have each been applied in specific clinical contexts. This article focuses on the differing definitions proposed in recent authoritative national and international guidelines and, in conjunction with clinical practice, suggests retaining the severity grading definition proposed in the 2017 GOLD report. Meanwhile, the grading system proposed by the Rome proposal should be further validated in future clinical practice, and its grading variables should be continuously optimized to better guide clinical management.