Gene R Pesola1,2, Habibul Ahsan1,3. 1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. 2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harlem Hospital/Columbia University, New York, NY, USA. 3. Department of Health Studies, Medicine, and Human Genetics and Cancer Research Center, University of Chicago, Chicago, IL, USA.
Abstract
BACKGROUND AND AIM: Dyspnea is a common and easily elicited presenting complaint in patients seen by physicians who evaluate and take care of chronic respiratory disorders. Although dyspnea is subjective and tends to increase with age or reduced lung function, it appears to be reproducible as a symptom and often signifies serious underlying disease. METHODS: Systematic review of longitudinal studies with dyspnea as the exposure and mortality as the outcome; age, smoking and lung function had to be controlled for to be included in the review. In addition, a minimum sample size at baseline of 500 subjects was required for each study. RESULTS: From over 3000 potential references, 10 longitudinal studies met all criteria and were included. All 10 studies suggested that dyspnea was an independent predictor of mortality with point estimates by odds ratio, rate ratio or hazard ratios ranging from 1.3 up to 2.9-fold greater than baseline. All 10 studies had actual or implied 95% confidence interval bands greater than the null value of one. CONCLUSION: Dyspnea, a symptom, predicts mortality and is a proxy for underlying diseases, most often of heart and lung. Therefore, chronic dyspnea needs to be evaluated as to etiology to allow for treatment to minimize morbidity and mortality when possible.
BACKGROUND AND AIM: Dyspnea is a common and easily elicited presenting complaint in patients seen by physicians who evaluate and take care of chronic respiratory disorders. Although dyspnea is subjective and tends to increase with age or reduced lung function, it appears to be reproducible as a symptom and often signifies serious underlying disease. METHODS: Systematic review of longitudinal studies with dyspnea as the exposure and mortality as the outcome; age, smoking and lung function had to be controlled for to be included in the review. In addition, a minimum sample size at baseline of 500 subjects was required for each study. RESULTS: From over 3000 potential references, 10 longitudinal studies met all criteria and were included. All 10 studies suggested that dyspnea was an independent predictor of mortality with point estimates by odds ratio, rate ratio or hazard ratios ranging from 1.3 up to 2.9-fold greater than baseline. All 10 studies had actual or implied 95% confidence interval bands greater than the null value of one. CONCLUSION:Dyspnea, a symptom, predicts mortality and is a proxy for underlying diseases, most often of heart and lung. Therefore, chronic dyspnea needs to be evaluated as to etiology to allow for treatment to minimize morbidity and mortality when possible.
Authors: Amy Berrington de Gonzalez; Patricia Hartge; James R Cerhan; Alan J Flint; Lindsay Hannan; Robert J MacInnis; Steven C Moore; Geoffrey S Tobias; Hoda Anton-Culver; Laura Beane Freeman; W Lawrence Beeson; Sandra L Clipp; Dallas R English; Aaron R Folsom; D Michal Freedman; Graham Giles; Niclas Hakansson; Katherine D Henderson; Judith Hoffman-Bolton; Jane A Hoppin; Karen L Koenig; I-Min Lee; Martha S Linet; Yikyung Park; Gaia Pocobelli; Arthur Schatzkin; Howard D Sesso; Elisabete Weiderpass; Bradley J Willcox; Alicja Wolk; Anne Zeleniuch-Jacquotte; Walter C Willett; Michael J Thun Journal: N Engl J Med Date: 2010-12-02 Impact factor: 91.245
Authors: Ravi Kalhan; Betty T Tran; Laura A Colangelo; Sharon R Rosenberg; Kiang Liu; Bharat Thyagarajan; David R Jacobs; Lewis J Smith Journal: PLoS One Date: 2010-07-02 Impact factor: 3.240
Authors: Bharat Thyagarajan; Lewis J Smith; R Graham Barr; Myron D Gross; Akshay Sood; Ravi Kalhan; David R Jacobs Journal: Chest Date: 2009-02-18 Impact factor: 9.410
Authors: F Rasmussen; D Mikkelsen; R J Hancox; J Lambrechtsen; M Nybo; H S Hansen; H C Siersted Journal: Eur Respir J Date: 2008-11-14 Impact factor: 16.671
Authors: Gene R Pesola; Maria Argos; Vernon M Chinchilli; Yu Chen; Faruque Parvez; Tariqul Islam; Alauddin Ahmed; Rabiul Hasan; Muhammad Rakibuz-Zaman; Habibul Ahsan Journal: J Epidemiol Community Health Date: 2016-01-14 Impact factor: 3.710
Authors: Debasree Banerjee; Jane Kamuren; Grayson L Baird; Amy Palmisciano; Ipsita Krishnan; Mary Whittenhall; James R Klinger; Corey E Ventetuolo Journal: Pulm Circ Date: 2017-03-16 Impact factor: 3.017
Authors: Diana H Ferreira; Slavica Kochovska; Aaron Honson; Jane L Phillips; David C Currow Journal: BMC Palliat Care Date: 2020-05-06 Impact factor: 3.234
Authors: Jacob Sandberg; Magnus Ekström; Mats Börjesson; Göran Bergström; Annika Rosengren; Oskar Angerås; Kjell Toren Journal: BMJ Open Respir Res Date: 2020-09