Work

Short and long-term prognosis of hospitalization for dyspnoea based on aetiology and hospitalization ward: insights from the PARADISE cohort

Year: 2026

Type: article

Abstract: 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.

Source: European Journal of Heart Failure

DOI: 10.1093/ejhf/xuaf027