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澳大利亚成年人呼吸困难的患病率和负担:全国呼吸困难调查——一项基于网络的横断面人群调查。

Prevalence and burden of breathlessness in Australian adults: The National Breathlessness Survey-a cross-sectional web-based population survey.

机构信息

Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.

IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.

出版信息

Respirology. 2021 Aug;26(8):768-775. doi: 10.1111/resp.14070. Epub 2021 May 10.

Abstract

BACKGROUND AND OBJECTIVE

Chronic respiratory symptoms (in particular, breathlessness and cough) can cause physical, social and emotional distress, and may indicate the presence of an underlying disease that presages future poor health outcomes. Our aim was to investigate the burden of breathlessness in Australian adults, including breathlessness that may be undiagnosed, unlabelled or untreated.

METHODS

The National Breathlessness Survey was a cross-sectional, web-based survey conducted in October 2019. Australian adults were randomly selected from a large web-based survey panel with recruitment stratified by age-group, gender and state of residence according to national population data. The main outcome measures were modified Medical Research Council (mMRC) dyspnoea scale, EuroQol visual analog scale, Dyspnoea-12 score and 4-item Patient Health Questionnaire (PHQ-4).

RESULTS

Among all respondents (n = 10,072; 51.1% female; median age group 40-49 years), 9.5% reported clinically important breathlessness (mMRC dyspnoea grade ≥ 2, 2 = 'I walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level'). Among those with clinically important breathlessness, 49.1% rated their general health as fair or poor and 44.2% had at least moderate depression or anxiety symptoms (PHQ ≥ 6) but over half (50.8%) did not report a current respiratory or heart condition diagnosis.

CONCLUSION

Breathlessness is common among Australian adults, and is associated with a substantial burden of ill health, including among people without a diagnosed respiratory or heart condition. The extent of underdiagnosis of these conditions or alternative causes of breathlessness requires further investigation.

摘要

背景和目的

慢性呼吸系统症状(尤其是呼吸困难和咳嗽)可导致身体、社交和情绪困扰,并可能表明存在预示未来健康状况不佳的潜在疾病。我们的目的是调查澳大利亚成年人呼吸困难的负担,包括可能未被诊断、未被标记或未经治疗的呼吸困难。

方法

全国呼吸困难调查是一项横断面、基于网络的调查,于 2019 年 10 月进行。澳大利亚成年人从一个大型基于网络的调查小组中随机选择,根据全国人口数据,按照年龄组、性别和居住州分层进行招募。主要结局指标为改良的医学研究理事会(mMRC)呼吸困难量表、欧洲五维健康量表视觉模拟评分、呼吸困难-12 评分和 4 项患者健康问卷(PHQ-4)。

结果

在所有受访者(n=10072;51.1%为女性;中位数年龄组为 40-49 岁)中,9.5%报告有临床意义的呼吸困难(mMRC 呼吸困难分级≥2,2=“因为呼吸困难,我走得比同龄人慢,或者在以自己的速度在平地行走时不得不停下来喘气”)。在有临床意义的呼吸困难患者中,49.1%自评总体健康状况为一般或较差,44.2%有至少中度抑郁或焦虑症状(PHQ≥6),但超过一半(50.8%)未报告当前有呼吸道或心脏疾病诊断。

结论

呼吸困难在澳大利亚成年人中很常见,与大量健康不良负担相关,包括在没有诊断出呼吸道或心脏疾病的人群中。这些疾病或其他导致呼吸困难的原因的未确诊程度需要进一步调查。

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