Breathlessness Predicts Mortality in Adults: A Systematic Review and Meta-Analysis.

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Clinical Prognostics

Background:

• Breathlessness is a common symptom with a known link to mortality in various conditions.
• The association between breathlessness and mortality in healthy adults remains less understood.
• Understanding this relationship is crucial for assessing the prognostic impact of breathlessness.

Purpose of the Study:

• To systematically review and meta-analyze the association between breathlessness and mortality in a general adult population.
• To determine if the presence and severity of breathlessness predict mortality in healthy adults.
• To quantify the increased risk of mortality associated with breathlessness.

Main Methods:

• Systematic review and meta-analysis of longitudinal studies.
• Searched Medline, EMBASE, CINAHL, and EMCARE for studies on breathlessness and mortality.
• Included studies of >1,000 healthy adults, assessing mortality in breathless vs. non-breathless individuals.

Main Results:

• 21 studies were included in the review, 19 in the meta-analysis, all of good quality with low risk of bias.
• The presence of breathlessness increased mortality risk by 43% (RR: 1.43, 95% CI: 1.28-1.61).
• Increased breathlessness severity correlated with higher mortality: mild (30% increase), severe (103% increase), and mMRC grade 4 (155% increase).

Conclusions:

• Breathlessness is significantly associated with increased mortality in the general adult population.
• The severity of breathlessness directly correlates with the magnitude of mortality risk.
• The underlying mechanisms require further investigation, potentially linked to breathlessness as a marker for various underlying diseases.