Seasonal variations of patients presenting dyspnea to emergency departments in Europe: Results from the EURODEM Study

Abstract

Background/aim: To describe seasonal variations in epidemiology, management and short-term outcomes of patients presenting to an emergency department (ED) with main complaint of dyspnea in Europe. Materials and Methods: An observational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during three 72-hours study periods. Data was collected on demographics, co-morbidities, chronic treatment, pre-hospital treatment, mode of arrival of patient to ED, clinical signs at admission, treatment in the ED, ED diagnosis, discharge from ED and in-hospital outcome. Results: The study included 2524 patients with the median age of 69 (53-80) years. Of those patients presented, 991 (39.3%) were in autumn, 849 (33.6%) were in spring and 48 (27.1%) were in winter. The winter population was significantly older (p<0.001) and had lower rate for ambulance arrival to ED (p<0.001). In winter period higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic and more hyper/hypo thermic compared with other seasons. The ED mortality was about 1% and in hospital mortality for admitted patients was 7.4%. Conclusion: The analytic method and the outcome of this study may help to guide to allocate ED resources efficiently, suggest seasonal ED management protocols based on seasonal trend of dyspneic patients.

Activities of Daily Living in Patients with Chronic Obstructive Pulmonary Disease: A Hybrid Concept Analysis

“…When patients experience dyspnea, they notice that they are not well, and therefore, they reduce their ADLs; however, this reduction in physical activity further exacerbates their dyspnea and results in subsequent immobility (44). Moreover, dyspnea is affected by factors such as anxiety, depression, emotional and mood components (45,46), and weather and climate changes (47,48). Most patients believe that environmental and emotional factors, such as air pollution, cold weather, happiness, and anxiety, affect their dyspnea.…”

Outcomes in Emergency Department Patients with Dyspnea versus Chest Pain: A Retrospective Consecutive Cohort Study

“…Dyspnea as a cause of contact was more common in the winter months compared to chest pain. A previous study suggests that ED dyspnea patients in the winter months are typically older and often have a lower respiratory tract infection, COPD, and/or heart failure [23].…”

Soluble CD146 in the detection and grading of intravascular and tissue congestion in patients with acute dyspnoea: analysis of the prospective observational Lithuanian Echocardiography Study of Dyspnoea in Acute Settings (LEDA) cohort

“…This difficulty is prevalent in the setting of acute dyspnoea, given often similar clinical presentations despite a diverse spectrum of aetiologies. [19][20][21] Delayed identification leads to delays in initiation of decongestive therapies in acute dyspnoea, although early diuretic administration has been related to a better outcome in AHF. 22 Recently, sCD146-a promising blood biomarker for congestion-has been introduced.…”