Discipline, Palliative and Supportive Services, Flinders University, Bedford Park, South Australia. Australia.
PLoS One. 2013 Sep 17;8(9):e74814. doi: 10.1371/journal.pone.0074814. eCollection 2013.
Breathlessness is a subjective sensation, so understanding its impacts requires patients' reports, including prospective patient-defined breathlessness as a reason for presenting to general practitioners (GP).The aim of this study was to define the prevalence of breathlessness as a reason for GP consultations while defining the clinico-demographic factors of these patients and the characteristics and outcomes of those consultations.
Using nine years of the Family Medicine Research Centre database of 100 consecutive encounters from 1,000 practices annually, the patient-defined reason for encounter 'breathlessness' was explored using prospectively collected data in people ≥ 18 years with clinical data coded using the International Classification for Primary Care V2. Dichotomous variables were analysed using chi square and 95% confidence intervals calculated using Kish's formula for a single stage clustered design.
Of all the 755,729 consultations collected over a nine year period from 1 April, 2000, 7255 included breathlessness as a reason for encounter (0.96%; 95% CI 0.93 to 0.99) most frequently attributed to chronic obstructive pulmonary disease. Only 48.3% of GPs saw someone reporting breathlessness. The proportion of consultations with breathlessness increased with age. Breathlessness trebled the likelihood that the consultation occurred in the community rather than the consulting room (p<0.0001) and increased 2.5 fold the likelihood of urgent referral to hospital (p<0.0001). Of those with breathlessness, 12% had undiagnosed breathlessness at the end of the consultation (873/7255) with higher likelihood of being younger females.
Breathlessness is a prevalent symptom in general practitioner. Such prevalence enables future research focused on understanding the temporal pattern of breathlessness and the longitudinal care offered to, and outcomes for these patients, including those who leave the consultation without a diagnosis.
呼吸困难是一种主观感觉，因此了解其影响需要患者的报告，包括前瞻性患者将呼吸困难定义为向全科医生（GP）就诊的原因。本研究的目的是定义呼吸困难作为 GP 就诊原因的患病率，同时定义这些患者的临床人口统计学特征以及这些就诊的特征和结果。
使用家庭医学研究中心数据库中的九年数据，该数据库每年从 1000 个实践中连续收集 100 个病例，使用前瞻性收集的≥18 岁患者的临床数据，使用国际初级保健分类 V2 编码数据，探索患者定义的就诊原因“呼吸困难”。使用卡方检验分析二分类变量，并使用 Kish 公式计算单阶段聚类设计的 95%置信区间。
在 2000 年 4 月 1 日至九年内收集的 755729 次就诊中，7255 次就诊将呼吸困难作为就诊原因（0.96%；95%CI 0.93 至 0.99），最常归因于慢性阻塞性肺疾病。只有 48.3%的 GP 看到有人报告呼吸困难。报告呼吸困难的就诊比例随着年龄的增长而增加。呼吸困难使就诊发生在社区而不是诊室的可能性增加了两倍（p<0.0001），并使紧急转院的可能性增加了 2.5 倍（p<0.0001）。在有呼吸困难的患者中，12%（873/7255）在就诊结束时呼吸困难未被诊断，更年轻的女性可能性更大。
呼吸困难是全科医生常见的症状。这种患病率使未来的研究能够专注于了解呼吸困难的时间模式和为这些患者提供的纵向护理，包括那些离开就诊时未被诊断的患者。
