BACKGROUND
Acute dyspnea is a distressing symptom associated with cardiac and pulmonary conditions, often 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
We conducted a population-based, multicenter cohort study involving non-trauma ED visits aged ≥18 years in the Region of Southern Denmark from January 1st, 2016, to March 20th, 2018. Associations between risk factors and 0–7- and 8–30-day mortality were analyzed using multivariable logistic regression.

RESULTS
A total of 26,329 ED visits with dyspnea as the primary complaint were included. The median age was 72 years (IQR 61–91), 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 (IQR 120–153), diastolic blood pressure 77 mmHg (IQR 67–88), heart rate 91 beats/min (IQR 78–106), respiratory rate 22 breaths/min (IQR 18–26), oxygen saturation 95% (IQR 92–98), oxygen supply 2 l/min (IQR 0–4), temperature 37.1°C (IQR 36.6–37.6), and Glasgow Coma Score (GCS) 15 (IQR 15–15). Discharge diagnoses were COPD (22.5%), pneumonia (20.5%), dyspnea (13.4%), ED visits for observation (6.2%), and respiratory failure (6.1%). Overall, 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 strongly associated with 8–30 days mortality.

CONCLUSIONS
ED visits for dyspnea were characterized by patients presenting with normal vital signs. Age emerged as a significant and increasingly important predictor of mortality over time, while low SBP, temperature, and GCS were specifically associated with 0–7-day mortality. These findings emphasize age as a critical prognostic factor in dyspnea-related ED visits, underscoring the importance of early recognition and appropriate dyspnea management in the ED to improve outcomes. Implementing timely, age-specific interventions can enhance patient care and optimize outcomes in this vulnerable population.