European Dyspnoea Survey in the EMergency Departments
European Dyspnoea Survey in the EMergency Departments
Braunwald defines dyspnoea as an abnormally uncomfortable awareness of breathing. Breathing
 discomfort, and its varying degrees of severity, is the one of the most disturbing symptoms
 patients can experience; and it is one of the main complaints in the patients presenting to
 the Emergency Department (ED). Dyspnea has a variety of underlying etiologies, like cardiac,
 pulmonary or metabolic etiologies or a combination of them, since several diseases can cause
 dyspnea like for instance heart failure (HF), asthma and chronic obstructive pulmonary
 disease (COPD).

 Acute heart failure syndrome (AHFS) is collectively defined as a gradual or rapid change in
 heart failure (HF) signs and symptoms resulting in a need for urgent therapy. Heart failure
 (HF) is one of the most important causes of morbidity and mortality in the industrialized
 world. The prevalence of symptomatic HF is estimated to range from 0.4 to 2.0% in general
 European population. The incidence increases rapidly with age, and in Europe.
 Characteristics, clinical presentation, treatment, and outcomes of HF patients admitted to
 hospital have been adequately described, in Europe and in the United States. The Euro Heart
 Failure Survey (EHFS) I with 11 327 patients described the demographics of acutely
 hospitalized HF patients. The ADHERE registry has data on over 100 000 hospitalizations for
 AHF from the USA. In-hospital mortality was 4 and 7%, in ADHERE and EHFS I, respectively.

 This same sensation of breathlessness is what also drives patients with asthma and chronic
 obstructive pulmonary disease (COPD) to the ED. Chronic obstructive pulmonary disease (COPD)
 exacerbation accounts for approximately 1.5 million ED visits in the United States per year.
 It is the third most common cause of hospitalization, with an estimated 726 000
 hospitalizations in 2000 in the USA. Previous studies have demonstrated important differences
 between guideline recommendations and actual management of COPD exacerbation, either in the
 ED or during hospitalization.

 The diagnosis in front of a dyspneic patient in the ED remains a challenge, because of a low
 sensitivity of the clinical signs associated with the aging of the population and the variety
 of underlying diseases. Little is known about the Epidemiology of dyspneic patients in the ED
 at the European level. Diagnosis, prevalence and treatment of the patients may vary among
 European countries.
MAIN OBJECTIVES

 -  Epidemiologic description of patients presenting to the ED with shortness of breath as
 main complaint.

 -  Description of current management in the ED of patients presenting to the ED with
 shortness of breath as main complaint.

 SECONDARY OBJECTIVES

 -  Sub analysis of ED discharged patients versus admitted patients for characteristics,
 comparison to recommended care and re-ED visit.

 -  Determine clinical and/or biological criteria to distinguish between:

 -  Patients who are treated as outpatients and admitted patients.

 -  Patients hospitalized in ward and patients admitted to intensive care units (CCU
 and ICU)

 -  Prognostic prediction, using clinical and biochemical data

 -  To determine if ED patients treated for acute heart failure differ from those admitted
 to hospital.

 -  Comparison of European data characteristics, investigation, treatment and outcome to
 similar data in other part of the world.
Inclusion Criteria:

 -  Consecutive patients presenting to the Emergency Department with Dyspnea as main
 complaint

 -  18 years or older

 Exclusion Criteria:

 -  No acceptance to participate from the patient