{
  "abstract": "Background and objective Breathlessness is associated with higher rates of unplanned health service utilisation. We aimed to evaluate any associations between the severity of breathlessness limiting exertion (hereafter breathlessness), time between breathlessness recording and subsequent unplanned hospital admissions, and length of stay.Methods A retrospective cohort study of adults seen in general practice (UK Clinical Practice Research Datalink) with breathlessness (Medical Research Council (MRC) breathlessness scale; 1–5; 5 is most intense), no pre-existing cardio-respiratory disease and a subsequent unplanned hospital admission. Data from 2007 to 2017 were used. By intensity of breathlessness, time to first unplanned admission and hospital length of stay were evaluated, the latter using negative binomial regression.Results 103 917 adults had breathlessness scores recorded, of which 16 948 used MRC. 11 911 (70%) adults had a subsequent unplanned hospital admission (median (IQR) of 1538 days (846–2258)) later. More intense breathlessness was associated with higher age, higher body mass index and being a smoker/ex-smoker.Length of time between a first-recorded breathlessness score and the first unplanned hospital admission decreased significantly with higher MRC scores (MRC 1: 1167 days; MRC 5: 615 days).Negative binomial regression showed an association between higher MRC scores and an increased length of inpatient stay (p<0.001; Akaike information criterion=20 817), controlling for key demographic factors.Conclusion This is the first study to identify an association between recording breathlessness intensity and time to a person’s first unplanned hospital admission and longer inpatient length of stay. Future work must focus on whether interventions can change people’s health service use.",
  "authors": [
    {
      "affiliations": [
        "NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Urvee Karsanji"
    },
    {
      "affiliations": [
        "Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"
      ],
      "name": "Vanessa N Brunelli"
    },
    {
      "affiliations": [
        "NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Claire A Lawson"
    },
    {
      "affiliations": [
        "Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK"
      ],
      "name": "Alex Bottle"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden"
      ],
      "name": "Magnus Ekström"
    },
    {
      "affiliations": [
        "Centre for Health Policy and Management, Trinity College Dublin, University of Dublin, Dublin, Ireland"
      ],
      "name": "Irina Kinchin"
    },
    {
      "affiliations": [
        "IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Slavica Kochovska"
    },
    {
      "affiliations": [
        "Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"
      ],
      "name": "Diana Ferreira"
    },
    {
      "affiliations": [
        "Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK"
      ],
      "name": "Jennifer K Quint"
    },
    {
      "affiliations": [
        "NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Michael C Steiner"
    },
    {
      "affiliations": [
        "NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Rachael A Evans"
    },
    {
      "affiliations": [
        "Flinders Ageing Alliance, Flinders University, Adelaide, South Australia, Australia"
      ],
      "name": "David C Currow"
    }
  ],
  "title": "Breathlessness intensity recorded in general practice is associated with shorter times to unplanned hospital admissions and longer lengths of stay: a UK cohort study",
  "uid": "ac6e9aa9-7480-5b46-973a-e424c42b70de"
}