Mehmet Akif Karamercan1, Zerrin Defne Dündar2, Mehmet Ergin3, Oene VAN Meer4, Richard Body5,6, Veli-Pekka Harjola7,8, Franck Verschuren9, Micheal Christ10, Adela Golea11, Jean Capsec12, Cinzia Barletta13, Luis Garcia-Castrillo14, Yusuf Ali Altuncı15, Yavuz Katırcı16, Anne-Maree Kelly17,18, Said Laribi19. 1. Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey 2. Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey 3. Department of Emergency Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey 4. Department of Emergency Medicine, Leiden University Medical Center, Leiden, Netherlands 5. Department of Emergency Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK 6. Department of Cardiovascular Sciences, The University of Manchester, Manchester, UK, 7. Department of Emergency Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland 8. Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland 9. Department of Acute Medicine, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium 10. Department of Emergency Medicine, Luzerner Kantonsspital, Luzern, Switzerland 11. Department of Emergency Medicine, County Emergency Hospital Cluj-Napoca, University of Medicine and Pharmacy, Cluj-Napoca, Romania 12. Department of Public Health, Tours University Hospital, Tours, France 13. Department of Emergency Medicine, Santa Eugenio Hospital, Rome, Italy 14. Servicio Urgencias Hospital Marqués de Valdecilla, Santander, Spain 15. Department of Emergency Medicine, Faculty of Medicine Hospital, Ege University, İzmir, Turkey 16. Department of Emergency Medicine, Ankara Education and Research Hospital, Ankara, Turkey 17. Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Australia 18. Department of Medicine, Melbourne Medical School – Western Precinct, The University of Melbourne, Melbourne, Australia 19. Department of Emergency Medicine, Faculty of Medicine, Tours University, Tours, France
Abstract
Background/aim: To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods: Anobservational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital 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 a median age of 69 (53–80) years old. Of the 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 a lower rate of ambulance arrival to ED (P < 0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to 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 the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients. This work is licensed under a Creative Commons Attribution 4.0 International License.
Background/aim: To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods: Anobservational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital 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 a median age of 69 (53–80) years old. Of the 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 a lower rate of ambulance arrival to ED (P < 0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to 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 the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients. This work is licensed under a Creative Commons Attribution 4.0 International License.
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