Background and aim:

Acute dyspnea is a distressing symptom frequently leading patients to seek emergency department (ED) care. This study aimed to describe the demographics and clinical characteristics of ED visits for dyspnea and investigate the association between risk factors and short-term mortality.
Methods and material:

A population-based, multicenter cohort study was conducted in the Region of Southern Denmark from January 2016 to March 2018. Non-trauma ED visits aged ≥ 18 years with dyspnea as the primary complaint were included. Multivariable logistic regression analysis was performed to examine the relationship between risk factors and 0–7- and 8–30-day mortality.
Results:

Overall, 26,329 ED visits with dyspnea as the primary complaint were included. The median age was 72 years, with 52% being females. Chronic obstructive pulmonary disease (COPD, 46%) and hypertension (32%) were common comorbidities. Median vital signs were systolic blood pressure (SBP) 136 mmHg, diastolic blood pressure 77 mmHg, heart rate 91 beats/min, respiratory rate 22 breaths/min, oxygen saturation 95%, oxygen supply 2 l/min, temperature 37.1°C, and Glasgow Coma Score (GCS) 15. Discharge diagnoses were COPD (22.5%), pneumonia (20.5%), dyspnea (13.4%), ED visits for observation (6.2%), and respiratory failure (6.1%). The 0–7 days mortality rate for the first visit was 4.2%, and the 8–30 days mortality rate was 3.7%. Age, SBP < 90, temperature < 34°C, and GCS < 13 were associated with 0-7 days mortality, while age alone remained associated with 8–30 days mortality.

Discussion and Conclusion:

ED visits for dyspnea often involved patients with normal vital signs. Age emerged as an increasingly important predictor of mortality over time, while low SPB, temperature, and GCS were associated with 0–7-day mortality. These findings highlight the significance of age as a critical prognostic factor and underscore the importance of early recognition and appropriate management of dyspnea in the ED to improve outcomes.