A landmark study from Harvard Medical School has uncovered a startling link between a common patient symptom and a dramatically increased risk of death in hospital. The research found that patients who report feeling short of breath face a mortality risk up to six times higher than those without this symptom.
The Critical Symptom Overlooked in Wards
Medically termed dyspnoea, this sensation of breathing discomfort affects as many as one in ten people admitted to hospital. It can manifest as a feeling of being starved for air, suffocation, or simply laboured breathing. Despite its prevalence, it is not routinely monitored in the same way as pain.
Scientists, led by Associate Professor Robert Banzett from Beth Israel Deaconess Medical Center, collaborated with nurses to assess nearly 10,000 patients. These patients were asked to rate their breathlessness on a scale from zero to ten twice daily. This simple method mirrored the established practice for questioning patients about their pain levels.
Severe Consequences for Patient Outcomes
The findings, published in the ERJ Open Research journal, were stark. While a patient's reported pain levels did not predict their likelihood of dying, their breathlessness scores did.
Patients suffering from the most severe dyspnoea were six times more likely to die compared to patients without breathlessness. The study also revealed these patients faced a higher risk of several serious outcomes, including:
- Needing care from a rapid response team
- Being transferred to intensive care
- Dying within two years of their hospital admission
- Being readmitted to hospital within seven days
- Being readmitted to hospital within 30 days
The prognosis was particularly grave for some. A quarter of patients who were still experiencing breathlessness while at rest upon discharge from hospital died within just six months.
A Call for Simple, Life-Saving Changes
Professor Banzett was keen to offer reassurance, stating, "It is important to note that dyspnoea is not a death sentence – even in the highest risk groups, 94% of patients survive hospitalisation, and 70% survive at least two years."
However, he emphasised the power of this new knowledge. "Knowing which patients are at risk with a simple, fast, and inexpensive assessment should allow better individualised care," he said. The research team strongly believes that integrating a routine question about shortness of breath into standard hospital procedures would help medical staff prioritise care more effectively and manage this often-frightening symptom.
This straightforward change in protocol could potentially save lives by identifying vulnerable patients earlier, ensuring they receive the urgent attention they need.
