title: The frequency and outcome of acute dyspnoea in primary care: An observational study.
abstract: BACKGROUND
  Little is known about the occurrence of acute dyspnoea in primary care and its underlying causes.
  
  
  OBJECTIVE
  What are the occurrence and most frequent causes of acute dyspnoea in primary care, predictors of referral, hospitalization, death and possible underlying causes?
  
  
  METHODS
  Twenty-five general practitioners (GPs) in Flanders (Belgium) recorded patient contacts for four periods of two weeks during one year. They recorded patients presenting with acute dyspnoea, location of contact (surgery versus home visit), new dyspnoea versus exacerbation, tentative diagnosis, referral to a specialist and hospital, and one month later final diagnosis, its justification, referral, hospitalization and death.
  
  
  RESULTS
  Twenty-two GPs recorded 14,620 patient contacts. Acute dyspnoea was encountered in 317 patient-doctor contacts (2.2%; 95%CI: 1.9-2.4), without significant association between the acute dyspnoea frequency, and age and gender. Immediate referral and hospitalization were most frequent in patients 61 to 90 years old. Forty-five patients (14.2%; 95%CI: 10.4-18.0) were referred to a specialist immediately and an additional 34 (10.7%; 95%CI: 7.3-14.1) by one month follow-up. Fourteen patients (4.4%) were hospitalized immediately, and 11 (3.5%) within one month. Six patients (1.9%), all 61 to 90 years old, died within one month.
  
  
  CONCLUSIONS
  Dyspnoea occurs in about two per cent of consultations. Serious cases are rare and are much more likely in the older age group. Twenty-five per cent of the contacts concerning acute or worsening dyspnoea were referred to a specialist or hospitalized. In daily practice, the risk of immediate referral, hospitalization and death is higher in men and older patients, especially if the contact is at the patient's home. [Box: see text].
authors.affiliation: a Department of General Practice, Department of Public Health and Primary Care , KU Leuven , Leuven , Belgium.
authors.forename: Karin
authors.initials: K
authors.lastname: von Winckelmann
authors.affiliation: a Department of General Practice, Department of Public Health and Primary Care , KU Leuven , Leuven , Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Renier
authors.affiliation: b Department of Primary Health Care , University of Oxford , Old Road Campus , Oxford , UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Thompson
authors.affiliation: a Department of General Practice, Department of Public Health and Primary Care , KU Leuven , Leuven , Belgium.|c Research Institute CAPHRI , University of Maastricht , The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012737:Sex Factors; D055815:Young Adult
keywords: Asthma/COPD; dyspnoea; epidemiology; general; general practice/family medicine; predictor; prevalence