According to a report from the Daily Mail, US researchers at Harvard Medical School asked doctors to ask patients to rate their breathlessness (dyspnoea) and pain on a scale from 0 to 10 as they arrived and during their hospital stays, then they tracked the patients’ outcomes.
Researchers tracked nearly 10,000 adults over the next two years for death, readmission, length of stay, and need for intensive care. The concerning results indicate that patients who reported feeling short of breath while in the hospital were six times more likely to die in the hospital, and those who reported experiencing shortness of breath when they arrived at the hospital were three times more likely to die. If patients rated their shortness of breath high on the scale from 1-10, their risk of death rose, too, according to the analysis.
From Daily Mail:
Patients with shortness of breath were also more likely to need care from a rapid response team and be transferred to intensive care.
Even after discharge, breathlessness continued to predict poor outcomes. people who were breathless in hospital had a 50–70 per cent higher chance of dying within two years.
Experts have called for patients to be asked about if they are experiencing shortness of breath when they are admitted to hospital, as the quick check—which takes just seconds—could potentially save lives.
Professor Robert Banzett, the study lead at Harvard Medical School, said, “It is important to note that dyspnoea is not a death sentence. Even in the highest risk groups, 94 per cent of patients survive hospitalization, and 70 per cent survived at least two years following hospitalization.”
“But knowing which patients are at risk with a simple, fast, and inexpensive assessment should allow better individualized care.”
Banzett said that hospital nurses “routinely ask patients to rate any pain they are experiencing, but this is not the case for dyspnoea,” and that researchers “believe that routinely asking patients to rate their shortness of breath will lead to better management of this often-frightening symptom.”
“In the past, our research has shown that most people are good at judging and reporting this symptom, he said.
The findings were published in ERJ Open Research. In the report, the researchers suggested that hospitals should monitor whether patients are struggling with shortness of breath during their stay to “improve symptom management” and help “identify patients at a higher concern” who warrant more medical attention.
Meanwhile, pain, which staff also asked patients to rank, had no link to increased death.
“Pain is also a useful warning system, but it does not usually warn of an existential threat,” Banzett said. “If you hit your thumb with a hammer, you’ll probably rate your pain 11 on a scale of 0-10, but there is no threat to your life.
“It is possible that specific kinds of pain, for instance in internal organs, may predict mortality, but this distinction is not made in clinical record of pain ratings.”
Shortness of breath may be a better predictor of death because “dyspnoea is an alert that the body is not getting enough oxygen in and carbon dioxide out,” Banzett explained. “Failure of this system is an existential threat. Sensors throughout the body, in the lungs, heart and other tissues, have evolved to report on the status at all times and provide early warning of impending failure accompanied by a strong emotional response.”
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