Sajadi Seyyed Mohammad Ali, Majidi Alireza, Abdollahimajd Fahimeh, Jalali Fatemeh
Department of Internal Medicine, Ali-Ebne-Abitaleb Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Emerg (Tehran). 2017;5(1):e62. Epub 2017 Mar 19.
History taking and physical examination help clinicians identify the patient's problem and effectively treat it. This study aimed to evaluate the descriptors of dyspnea in patients presenting to emergency department (ED) with asthma, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD).
This cross-sectional study was conducted on all patients presenting to ED with chief complaint of dyspnea, during 2 years. The patients were asked to describe their dyspnea by choosing three items from the valid and reliable questionnaire or articulating their sensation. The relationship between dyspnea descriptors and underlying cause of symptom was evaluated using SPSS version 16.
312 patients with the mean age of 60.96±17.01 years were evaluated (53.2% male). Most of the patients were > 65 years old (48.7%) and had basic level of education (76.9%). "My breath doesn't go out all the way" with 83.1%, "My chest feels tight " with 45.8%, and "I feel that my airway is obstructed" with 40.7%, were the most frequent dyspnea descriptors in asthma patients. "My breathing requires work" with 46.3%, "I feel that I am suffocating" with 31.5%, and "My breath doesn't go out all the way" with 29.6%, were the most frequent dyspnea descriptors in COPD patients. "My breathing is heavy" with 74.4%, "A hunger for more air" with 24.4%, and "I cannot get enough air" with 23.2%, were the most frequent dyspnea descriptors in CHF patients. Except for "My breath does not go in all the way", there was significant correlation between studied dyspnea descriptors and underlying disease (p = 0.001 for all analyses).
It seems that dyspnea descriptors along with other findings from history and physical examination could be helpful in differentiating the causes of the symptom in patients presenting to ED suffering from dyspnea.
病史采集和体格检查有助于临床医生识别患者的问题并进行有效治疗。本研究旨在评估因哮喘、充血性心力衰竭（CHF）和慢性阻塞性肺疾病（COPD）就诊于急诊科（ED）的患者的呼吸困难描述词。
本横断面研究对2年内因呼吸困难为主诉就诊于急诊科的所有患者进行。要求患者从有效且可靠的问卷中选择三项或阐述自身感受来描述其呼吸困难。使用SPSS 16版评估呼吸困难描述词与症状潜在病因之间的关系。
共评估了312例患者，平均年龄为60.96±17.01岁（男性占53.2%）。大多数患者年龄>65岁（48.7%），且为基础教育水平（76.9%）。哮喘患者中最常见的呼吸困难描述词为“我的气出不净”（83.1%）、“我的胸部发紧”（45.8%）和“我感觉气道受阻”（40.7%）。COPD患者中最常见的呼吸困难描述词为“我呼吸费劲”（46.3%）、“我感觉快要窒息了”（31.5%）和“我的气出不净”（29.6%）。CHF患者中最常见的呼吸困难描述词为“我的呼吸沉重”（74.4%）、“渴望更多空气”（24.4%）和“我无法获得足够的空气”（23.2%）。除“我的气吸不净”外，所研究的呼吸困难描述词与潜在疾病之间存在显著相关性（所有分析p = 0.001）。
呼吸困难描述词以及病史和体格检查的其他结果似乎有助于区分因呼吸困难就诊于急诊科的患者的症状病因。
