Shortness of Breath, Rather Than Pain, May Be a More Critical Warning Sign in Hospital Patients
When you find yourself at the emergency room, one of the first things often asked is how much pain you are in. Although we may associate the severity level of pain as an indication of how in danger we are, new research suggests another symptom may be even more important: shortness of breath.
In one of the first studies to track breathing discomfort as carefully as pain, researchers found that hospital patients who developed shortness of breath were six times more likely to die than those who didn’t.
The findings, published in ERJ Open Research, suggest that a quick, 45-second check-in could help doctors and nurses identify patients in trouble sooner and potentially save thousands of lives.
Read More: Each One of Us Has a Unique Breathing Fingerprint – And This Is What It Says About Your Health
Why Shortness of Breath Is a Serious Warning Sign
Shortness of breath — otherwise known as dyspnoea — isn’t just uncomfortable. It can be a signal that the body’s oxygen and carbon dioxide systems are under threat.
“The sensation of dyspnoea, or breathing discomfort, is a really unpleasant symptom. Some people experience it as feeling starved of air or suffocated,” said Robert Banzett, Associate Professor at Harvard Medical School, in a press release. “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.”
Unlike pain, which often warns of a localized issue, shortness of breath can signal a problem with the lungs, heart, or both.
According to the Mayo Clinic, shortness of breath can stem from conditions like heart failure, fluid buildup in the lungs, asthma, or pulmonary embolism, to name a few. It acts like a bodily alarm that something is wrong with the system that keeps us alive, which may be why researchers found it so closely tied to the risk of death in hospitalized patients.
The Connection Between Dyspnoea and Death
In this study, researchers examined 9,785 adult patients admitted to Beth Israel Deaconess Medical Center in Boston, MA, between March 2014 and September 2016. Nurses asked patients to rate their shortness of breath twice per day on a scale from 0 to 10, a system similar to the standard pain rating chart.
When researchers compared these ratings with what happened to the patients once they were discharged, the results were concerning. Patients who developed shortness of breath after being admitted were six times more likely to die than those who didn’t.
The effects also extended beyond immediate hospitalization. Among patients who reported feeling short of breath at rest, 25 percent died within six months of being discharged, compared to only seven percent of those who had not experienced dyspnoea. Patients with shortness of breath were also more likely to need rapid response interventions or be transferred to intensive care.
Surprisingly, the study found no link between pain and increased risk of death. This suggests that while pain may be distressing, it’s not usually an accurate indicator of a life-threatening condition.
“Pain is also a useful warning system, but it does not usually warn of an existential threat,” explained Banzett. “If you hit your thumb with a hammer, you will probably rate your pain 11 on a scale of 0-10, but there is no threat to your life.”
A Simple Question That Could Save Lives
Since the study is the first of its kind, the research team emphasizes that their findings should be confirmed in hospitals worldwide. However, even without further studies, researchers believe that simply asking patients if they are feeling short of breath could help healthcare workers identify those most at risk.
“It is important to note that dyspnoea is not a death sentence,” Banzett concluded. “But knowing which patients are at risk with a simple, fast, and inexpensive assessment should allow better individualized care.”
Read More: Deep, Slow Breathing: An Antidote to Our Age of Anxiety?
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