Socioeconomic and clinical predictors of mortality in patients with acute dyspnea
Wessman, Torgny LU ; Tofik, Rafid LU ; Ruge, Thoralph LU and Melander, Olle LU
(2021)
In Open Access Emergency Medicine
13.
p.107-116
- Abstract
Background: Factors predicting long-term prognosis in patients with acute dyspnea may guide both acute management and follow-up. The aim of this study was to identify socioeconomic and clinical risk factors for all-cause mortality among acute dyspnea patients admitted to an Emergency Department. Methods: We included 798 patients with acute dyspnea admitted to the ED of Skåne University Hospital, Malmö, Sweden from 2013 to 2016. Exposures were living in the immigrant-dense urban part of Malmö (IDUD), country of birth, annual income, comorbidities, smoking habits, medical triage priority and severity of dyspnea. Mean follow-up time was 2.2 years. Exposures were related to risk of all-cause mortality using Cox proportional hazard model.... (More)
Background: Factors predicting long-term prognosis in patients with acute dyspnea may guide both acute management and follow-up. The aim of this study was to identify socioeconomic and clinical risk factors for all-cause mortality among acute dyspnea patients admitted to an Emergency Department. Methods: We included 798 patients with acute dyspnea admitted to the ED of Skåne University Hospital, Malmö, Sweden from 2013 to 2016. Exposures were living in the immigrant-dense urban part of Malmö (IDUD), country of birth, annual income, comorbidities, smoking habits, medical triage priority and severity of dyspnea. Mean follow-up time was 2.2 years. Exposures were related to risk of all-cause mortality using Cox proportional hazard model. Results: During follow-up 40% died. In models adjusted for age and gender, low annual income, previous or ongoing smoking, certain comorbidities, high medical triage priority and severe dyspnea were all significantly associated with increased mortality. After adjusting for age, gender and all significant exposures, the lowest quintile of income, ongoing or previous smoking, history of serious infection, anemia, hip fracture, high medical triage priority and severe dyspnea significantly and independently predicted mortality. In contrast, neither country of birth nor living in IDUD predicted a mortality risk. Conclusion: Apart from several clinical risk factors, low annual income predicts two-year mortality risk in patients with acute dyspnea. This is not the case for country of birth and living in IDUD. Our results underline the wide range of mortality risk factors in acute dyspnea patients. Knowledge of patients’ annual income as well as certain clinical features may aid risk stratification and determining the need of follow-up both in hospital and after discharge from an ED.
(Less)
- author
- Wessman, Torgny
LU
; Tofik, Rafid
LU
; Ruge, Thoralph
LU
and Melander, Olle
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acute dyspnea, Comorbidity, Emergency department, Immigrant, METTS, Mortality, Risk factor, Smoking, Socioeconomic status
- in
- Open Access Emergency Medicine
- volume
- 13
- pages
- 10 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:33790664
- scopus:85103938381
- ISSN
- 1179-1500
- DOI
- 10.2147/OAEM.S277448
- project
- MOVING FROM BIOMARKERS TO MECHANISM ORIENTED PREVENTION OF CARDIOMETABOLIC DISEASE
- language
- English
- LU publication?
- yes
- id
- 21c5b02e-48c5-4310-887c-4ac8259334e4
- date added to LUP
- 2021-04-21 08:07:51
- date last changed
- 2024-11-03 00:42:43
@article{21c5b02e-48c5-4310-887c-4ac8259334e4,
abstract = {{<p>Background: Factors predicting long-term prognosis in patients with acute dyspnea may guide both acute management and follow-up. The aim of this study was to identify socioeconomic and clinical risk factors for all-cause mortality among acute dyspnea patients admitted to an Emergency Department. Methods: We included 798 patients with acute dyspnea admitted to the ED of Skåne University Hospital, Malmö, Sweden from 2013 to 2016. Exposures were living in the immigrant-dense urban part of Malmö (IDUD), country of birth, annual income, comorbidities, smoking habits, medical triage priority and severity of dyspnea. Mean follow-up time was 2.2 years. Exposures were related to risk of all-cause mortality using Cox proportional hazard model. Results: During follow-up 40% died. In models adjusted for age and gender, low annual income, previous or ongoing smoking, certain comorbidities, high medical triage priority and severe dyspnea were all significantly associated with increased mortality. After adjusting for age, gender and all significant exposures, the lowest quintile of income, ongoing or previous smoking, history of serious infection, anemia, hip fracture, high medical triage priority and severe dyspnea significantly and independently predicted mortality. In contrast, neither country of birth nor living in IDUD predicted a mortality risk. Conclusion: Apart from several clinical risk factors, low annual income predicts two-year mortality risk in patients with acute dyspnea. This is not the case for country of birth and living in IDUD. Our results underline the wide range of mortality risk factors in acute dyspnea patients. Knowledge of patients’ annual income as well as certain clinical features may aid risk stratification and determining the need of follow-up both in hospital and after discharge from an ED.</p>}},
author = {{Wessman, Torgny and Tofik, Rafid and Ruge, Thoralph and Melander, Olle}},
issn = {{1179-1500}},
keywords = {{Acute dyspnea; Comorbidity; Emergency department; Immigrant; METTS; Mortality; Risk factor; Smoking; Socioeconomic status}},
language = {{eng}},
pages = {{107--116}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Open Access Emergency Medicine}},
title = {{Socioeconomic and clinical predictors of mortality in patients with acute dyspnea}},
url = {{http://dx.doi.org/10.2147/OAEM.S277448}},
doi = {{10.2147/OAEM.S277448}},
volume = {{13}},
year = {{2021}},
}