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Eur J Emerg Med. 2018 Aug 30. doi: 10.1097/MEJ.0000000000000571. [Epub ahead of print]

Epidemiology of patients presenting with dyspnea to emergency departments in Europe and the Asia-Pacific region.

Author information

1
Tours University.
2
Department of Emergency Medicine, Tours University Hospital, Tours.
3
Department of Emergency Medicine, Gold Coast University Hospital.
4
Faculty of Health Sciences and Medicine, Bond University.
5
School of Medicine, Griffith University, Gold Coast.
6
Leiden University Medical Center, Leiden, the Netherlands.
7
Joseph Epstein Centre for Emergency Medicine Research at Western Health, Sunshine, Queensland.
8
INSERM, U942, BIOmarkers in CArdioNeuroVAScular diseases.
9
Department of Anesthesiology and Critical Care, APHP, Saint Louis Lariboisière Hospitals, Paris, France.
10
Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
11
Department of Emergency Medicine, National University Hospital, National University Health System, Singapore.
12
Emergency Department, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road.
13
Cardiovascular Sciences Research Group, the University of Manchester, Manchester, England.
14
Department of Adult Emergency Medicine, Auckland City Hospital, Auckland, New Zealand.
15
Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
16
Department of Emergency Medicine, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
17
Emergency Department, Monash Medical Centre.
18
School of Clinical Sciences at Monash Health, Monash University, Clayton.
19
Department of Emergency Medicine and Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
20
Department of Emergency Medicine, Liverpool Hospital, University of New South Wales (Southwest Clinical School), Sydney, New South Wales.
21
Emergency Department of the University County Emergency Hospital, University of Medicine and Pharmacy, Cluj Napoca, Romania.
22
Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (SAR).
23
Department of Acute Medicine, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
24
Department of Emergency Care, Luzerner Kantonsspital, Luzern, Switzerland.
25
Paracelsus Medical University, Nuremberg, Germany.
26
Department of Emergency Medicine, St. Eugenio Hospital, Rome, Italy.
27
Servicio Urgencias Hospital Marqués de Valdecilla, Santander, Spain.
28
Joseph Epstein Centre for Emergency Medicine Research, Western Health.
29
Department of Medicine, Melbourne Medical School - Western Precinct, The University of Melbourne, St. Albans, Victoria, Australia.

Abstract

OBJECTIVE:

The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations.

PATIENTS AND METHODS:

An observational prospective cohort study was carried out in Europe and the Asia-Pacific region. The study included consecutive patients presenting to EDs with dyspnea as the main complaint. Data were collected on demographics, comorbidities, chronic treatment, clinical signs and investigations, treatment in the ED, diagnosis, and disposition from ED.

RESULTS:

A total of 5569 patients were included in the study. The most common ED diagnoses were lower respiratory tract infection (LRTI) (24.9%), heart failure (HF) (17.3%), chronic obstructive pulmonary disease (COPD) exacerbation (15.8%), and asthma (10.5%) in the overall population. There were more LRTI, HF, and COPD exacerbations in the EURODEM population, whereas asthma was more frequent in the AANZDEM population. ICU admission rates were 5.5%. ED mortality was 0.6%. The overall in-hospital mortality was 5.0%. In-hospital mortality rates were 8.7% for LRTI, 7.6% for HF, and 5.6% for COPD patients.

CONCLUSION:

Dyspnea as a symptom in the ED has high ward and ICU admission rates. A variety of causes of dyspnea were observed in this study, with chronic diseases accounting for a major proportion.

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