CLINICAL PROFILE AND OUTCOMES OF PATIENTS PRESENTING WITH ACUTE DYSPNEA TO THE EMERGENCY DEPARTMENT

Abstract

Background: Acute dyspnea is one of the most frequent and potentially life-threatening reasons for emergency department (ED) visits. Rapid identification of the underlying etiology and early risk stratification are essential for timely management and improved clinical outcomes. Objectives: To evaluate the clinical profile, etiological spectrum, emergency management, and outcomes of patients presenting with acute dyspnea to the emergency department of a tertiary care teaching hospital and to identify factors associated with adverse clinical outcomes. Materials and Methods: This hospital-based prospective observational study included 350 consecutive adult patients presenting with acute dyspnea over a 12-month period. Demographic characteristics, clinical presentation, comorbidities, vital signs, diagnostic investigations, emergency interventions, and patient outcomes were recorded using a predesigned case-record form. Statistical analysis was performed using appropriate parametric and non-parametric tests, with a p-value <0.05 considered statistically significant. Results: The mean age of the patients was 58.4±16.2 years, and 61.1% were males. Acute exacerbation of COPD (29.4%) was the most common cause of dyspnea, followed by acute heart failure (22.6%) and pneumonia (19.4%). Oxygen therapy was required in 94.9% of patients, while 21.1% received non-invasive ventilation and 10.9% required mechanical ventilation. Nearly half of the patients (48.9%) were admitted to general wards, 23.4% required ICU admission, and the overall in-hospital mortality was 4.6%. Older age, COPD, heart failure, oxygen saturation below 90%, and reduced Glasgow Coma Scale scores were significantly associated with ICU admission, whereas advanced age, severe hypoxemia, mechanical ventilation, ICU admission, and septic shock were significant predictors of in-hospital mortality (p<0.05). Conclusion: Acute exacerbation of COPD, acute heart failure, and pneumonia were the leading causes of acute dyspnea in the emergency department. Older age, cardiopulmonary comorbidities, hypoxemia, altered consciousness, and the need for ventilatory support were associated with poor clinical outcomes. Early recognition of high-risk patients and prompt emergency management may improve survival and optimize utilization of critical care resources.