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Short and long-term prognosis of hospitalization for dyspnoea based on aetiology and hospitalization ward: insights from the PARADISE cohort

Baudry, Guillaume ; Lacomblez, Claire ; Bresso, Emmanuel ; Monzo, Luca ; Mebazaa, Alexandre ; Duarte, Kevin ; Jaeger, Déborah ; Bassand, Adrien ; Buessler, Aurélien and Giacomin, Gaetan , et al. (2026) In European Journal of Heart Failure p.1-11
Abstract
Aims
Dyspnoea accounts for nearly 5% of emergency department (ED) visits. Our aim was to describe the in-hospital and long-term outcomes of patients admitted to the ED for dyspnoea, based on their underlying aetiology, and to determine if prognosis varies according to the hospitalization setting.

Methods
We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency—NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or... (More)
Aims
Dyspnoea accounts for nearly 5% of emergency department (ED) visits. Our aim was to describe the in-hospital and long-term outcomes of patients admitted to the ED for dyspnoea, based on their underlying aetiology, and to determine if prognosis varies according to the hospitalization setting.

Methods
We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency—NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or asthma.

Results
RI (30%), AHF (28%), and COPD (13%) were the predominant discharge diagnoses. In-hospital mortality stood at 12% overall, ranging from 1.1% in asthma to 15% in AHF and RI. Five-year all-cause mortality for patients discharged alive was 75% in AHF, 66% in RI, 62% in COPD, 37% in PE, and 26% in asthma. Hospitalization in specialized wards was associated with significantly reduced in-hospital mortality across all aetiologies, and with a decreased long-term mortality for RI and AHF (adjusted-HR 0.90, 95% CI 0.82–0.99, P = 0.02 for RI and adjusted-HR 0.90, 95% CI 0.82–0.99, P = 0.03 for AHF).

Conclusion
Patients hospitalized for dyspnoea face a high-risk of mortality both in-hospital and post-discharge. In view of the strikingly high mortality in dyspneic patients and the potential benefits of specialized management, our study calls for rapidly setting up personalized in-hospital and post-discharge dyspnoea pathways. (Less)
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
European Journal of Heart Failure
article number
xuaf027
pages
1 - 11
publisher
Elsevier
ISSN
1879-0844
DOI
10.1093/ejhf/xuaf027
language
English
LU publication?
yes
id
c205ad8a-c598-4ce7-a844-cc7afa3a680f
date added to LUP
2026-01-29 09:24:32
date last changed
2026-01-29 09:24:32
@article{c205ad8a-c598-4ce7-a844-cc7afa3a680f,
  abstract     = {{Aims<br/>Dyspnoea accounts for nearly 5% of emergency department (ED) visits. Our aim was to describe the in-hospital and long-term outcomes of patients admitted to the ED for dyspnoea, based on their underlying aetiology, and to determine if prognosis varies according to the hospitalization setting.<br/><br/>Methods<br/>We analyzed 18 903 consecutive patients (48% male, average age 73 years) hospitalized after an ED visit for dyspnoea from January 2010 to December 2019, as part of the PARADISE cohort (PAthwAy of Dyspneic patIent in Emergency—NCT02800122). Dyspnoea causes were classified as acute heart failure (AHF), respiratory infection (RI), chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), or asthma.<br/><br/>Results<br/>RI (30%), AHF (28%), and COPD (13%) were the predominant discharge diagnoses. In-hospital mortality stood at 12% overall, ranging from 1.1% in asthma to 15% in AHF and RI. Five-year all-cause mortality for patients discharged alive was 75% in AHF, 66% in RI, 62% in COPD, 37% in PE, and 26% in asthma. Hospitalization in specialized wards was associated with significantly reduced in-hospital mortality across all aetiologies, and with a decreased long-term mortality for RI and AHF (adjusted-HR 0.90, 95% CI 0.82–0.99, P = 0.02 for RI and adjusted-HR 0.90, 95% CI 0.82–0.99, P = 0.03 for AHF).<br/><br/>Conclusion<br/>Patients hospitalized for dyspnoea face a high-risk of mortality both in-hospital and post-discharge. In view of the strikingly high mortality in dyspneic patients and the potential benefits of specialized management, our study calls for rapidly setting up personalized in-hospital and post-discharge dyspnoea pathways.}},
  author       = {{Baudry, Guillaume and Lacomblez, Claire and Bresso, Emmanuel and Monzo, Luca and Mebazaa, Alexandre and Duarte, Kevin and Jaeger, Déborah and Bassand, Adrien and Buessler, Aurélien and Giacomin, Gaetan and Duchanois, Charlène and Wessman, Torgny and Zannad, Faiez and Chouihed, Tahar and Girerd, Nicolas}},
  issn         = {{1879-0844}},
  language     = {{eng}},
  pages        = {{1--11}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Heart Failure}},
  title        = {{Short and long-term prognosis of hospitalization for dyspnoea based on aetiology and hospitalization ward: insights from the PARADISE cohort}},
  url          = {{http://dx.doi.org/10.1093/ejhf/xuaf027}},
  doi          = {{10.1093/ejhf/xuaf027}},
  year         = {{2026}},
}