Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study: Rationale, design and analysis.
OBJECTIVE
Shortness of breath is a common reason for ED attendance. This international study aims to describe the epidemiology of dyspnoea presenting to EDs in the South East Asia-Pacific region, to compare disease patterns across regions, to understand how conditions are investigated and treated, and to assess quality of care.


METHODS
This is a prospective, interrupted time series cohort study conducted in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of consecutive adult patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72 h periods in May, August and October 2014 (autumn, winter and spring), and included demographics, comorbidities, mode of arrival, usual medications, pre-hospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome and final hospital diagnosis. The primary outcomes of interest are the epidemiology and outcome of patients presenting to ED with dyspnoea. Secondary outcomes of interest are seasonal and geographic comparisons of diagnoses and outcomes, disease-specific descriptions of epidemiology, investigation, treatment and disposition, and compliance with treatment guidelines.


CONCLUSIONS
This novel study will explore dyspnoea from the viewpoint of the patient's symptom (shortness of breath) rather than that of a single disease. The results will provide robust data about the epidemiology, investigation, treatment and disposition of this diverse patient group. The obtained data also have the potential to inform service planning and to quantify the proportion of patients with mixed cardiac and respiratory disease.
Joseph Epstein Centre for Emergency Medicine Research @ Western Health, Sunshine Hospital, Melbourne, Victoria, Australia.|Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Anne-Maree
AM
Kelly
Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.|School of Medicine, Bond University, Gold Coast, Queensland, Australia.|School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Gerben
G
Keijzers
Joseph Epstein Centre for Emergency Medicine Research @ Western Health, Sunshine Hospital, Melbourne, Victoria, Australia.
Sharon
S
Klim
Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR.
Colin A
CA
Graham
Emergency Department, Monash Medical Centre, Melbourne, Victoria, Australia.|School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Simon
S
Craig
Emergency Medicine Department, National University Health System, Singapore.|Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Win Sen
WS
Kuan
Department of Emergency Medicine, Auckland City Hospital, Auckland, New Zealand.
Peter
P
Jones
Department of Emergency Medicine, Liverpool Hospital, Sydney, New South Wales, Australia.|University of New South Wales (Southwest Clinical School), Sydney, New South Wales, Australia.
Anna
A
Holdgate
Statistical Consulting Service, Victoria University, Melbourne, Victoria, Australia.
Charles
C
Lawoko
Department of Emergency Medicine, Saint Louis Lariboisiere Hospitals, Paris, France.
Said
S
Laribi
D000328:Adult; D001315:Australia / Q000453:epidemiology; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D065186:Interrupted Time Series Analysis; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards; D012846:Singapore / Q000453:epidemiology
dyspnoea; emergency department; epidemiology