European journal of heart failure · 2026
Short and long-term prognosis of hospitalization for dyspnoea based on aetiology and hospitalization ward: insights from the PARADISE cohort.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Baudry Guillaume, Lacomblez Claire, Bresso Emmanuel, Monzo Luca, Mebazaa Alexandre, Duarte Kevin, Jaeger Déborah, Bassand Adrien, Buessler Aurélien, Giacomin Gaetan, Duchanois Charlène, Wessman Torgny, Zannad Faiez, Chouihed Tahar, Girerd Nicolas
Аннотация
AIMS: Dyspnoea accounts for nearly 5% of emergency department (ED) visits. Our aim was to describe the in-hospital and long-term outcomes of patients admitted to the ED for dyspnoea, based on their underlying aetiology, and to determine if prognosis varies according to the hospitalization setting.
METHODS: We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency-NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or asthma.
RESULTS: RI (30%), AHF (28%), and COPD (13%) were the predominant discharge diagnoses. In-hospital mortality stood at 12% overall, ranging from 1.1% in asthma to 15% in AHF and RI. Five-year all-cause mortality for patients discharged alive was 75% in AHF, 66% in RI, 62% in COPD, 37% in PE, and 26% in asthma. Hospitalization in specialized wards was associated with significantly reduced in-hospital mortality across all aetiologies, and with a decreased long-term mortality for RI and AHF (adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.02 for RI and adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.03 for AHF).
CONCLUSION: Patients hospitalized for dyspnoea face a high-risk of mortality both in-hospital and post-discharge. In view of the strikingly high mortality in dyspneic patients and the potential benefits of specialized management, our study calls for rapidly setting up personalized in-hospital and post-discharge dyspnoea pathways.
METHODS: We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency-NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or asthma.
RESULTS: RI (30%), AHF (28%), and COPD (13%) were the predominant discharge diagnoses. In-hospital mortality stood at 12% overall, ranging from 1.1% in asthma to 15% in AHF and RI. Five-year all-cause mortality for patients discharged alive was 75% in AHF, 66% in RI, 62% in COPD, 37% in PE, and 26% in asthma. Hospitalization in specialized wards was associated with significantly reduced in-hospital mortality across all aetiologies, and with a decreased long-term mortality for RI and AHF (adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.02 for RI and adjusted-HR 0.90, 95% CI 0.82-0.99, P = 0.03 for AHF).
CONCLUSION: Patients hospitalized for dyspnoea face a high-risk of mortality both in-hospital and post-discharge. In view of the strikingly high mortality in dyspneic patients and the potential benefits of specialized management, our study calls for rapidly setting up personalized in-hospital and post-discharge dyspnoea pathways.