Patients who develop shortness of breath during their hospital stay face a dramatically increased risk of death, according to alarming new research from Harvard Medical School.
The Critical Warning Sign Hospitals Are Missing
A comprehensive study examining nearly 10,000 adults has revealed that feeling short of breath could be one of the most important indicators of patient survival. The research team discovered that patients who developed breathing difficulties during their hospitalisation were six times more likely to die compared to those without such symptoms.
Professor Robert Banzett, the study's lead researcher, explained the significance of these findings: "The sensation of dyspnoea is an alert that the body is not getting enough oxygen in and carbon dioxide out. Failure of this system is an existential threat."
How the Groundbreaking Study Was Conducted
The research team analysed data from 10,000 adult patients who reported breathing issues upon admission to hospital. The majority of participants (77%) entered through emergency departments, making the findings particularly relevant for NHS emergency care.
Medical staff were instructed to ask patients to rate their breathlessness and pain on a scale from 0 to 10 upon arrival and throughout their hospital stay. Researchers then tracked patient outcomes over two years, monitoring mortality rates, readmissions, length of stay, and intensive care requirements.
The results were striking: patients reporting shortness of breath upon arrival had a three-fold increased risk of dying, while those who developed it during their stay faced the six-fold higher mortality risk.
Long-Term Implications and Expert Recommendations
The concerning patterns extended beyond hospital discharge. Patients who experienced breathlessness during hospitalisation had a 50-70% higher chance of dying within two years after leaving hospital.
Professor Banzett emphasised that while the findings are significant, "dyspnoea is not a death sentence. Even in the highest risk groups, 94% of patients survive hospitalisation, and 70% survived at least two years following hospitalisation."
Experts are now calling for routine breathlessness assessments in hospitals, similar to the pain scoring systems already in place. Hilary Pinnock from the University of Edinburgh commented: "It is interesting to read about the association of subject breathlessness with mortality and other adverse outcomes. Breathlessness was assessed on a zero to 10 scale which took less than a minute to administer."
Dr Cláudia Almeida Vicente, a GP and chair of the European Respiratory Society's primary care group, added: "This study highlights how a simple dyspnoea rating can serve as a strong, early warning sign of clinical decline. New-onset breathlessness during hospitalisation carried especially high risk, far exceeding that associated with pain."
The research, published in ERJ Open Research, suggests that implementing routine breathlessness monitoring could "improve symptom management" and help "identify patients at a higher concern" who need more urgent medical attention.
