Feeling breathless in hospital could be a far more serious warning sign than anyone realised, new research has revealed, with patients who struggle to breathe six times more likely to die than those breathing normally.
The study of nearly 10,000 people found that a simple 45-second check could help identify those most at risk.
Nurses asked patients to rate their breathing difficulty from zero to ten, just like they do with pain.
But while breathing problems proved deadly serious, pain levels showed no clear connection to whether patients survived.
Dyspnoea is an alert that the body is not getting enough oxygen
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It’s a finding that could transform how hospitals monitor their patients.
The research team at Beth Israel Deaconess Medical Center in Boston tracked patients admitted between March 2014 and September 2016.
Nurses documented how breathless each patient felt twice every day, creating a massive dataset that researchers could analyse alongside health outcomes over the following two years.
Associate Professor Robert Banzett, who led the study, explained that people experience breathlessness in truly frightening ways – some describe it as feeling starved of air or suffocated.
Despite how awful this symptom feels, hospitals haven’t routinely asked patients about it the way they check pain levels.
The assessment takes less than a minute to ask patients how breathless they feel and record their answer on that zero-to-10 scale.
The numbers paint a stark picture, as a quarter of patients who left the hospital still feeling breathless died within six months.
Compare that to just seven per cent mortality among those who breathed easily during their stay.
Patients with breathing difficulties also needed more urgent care while in hospital.
They were more likely to require rapid response teams and transfers to intensive care units.
The worse their breathlessness rating, the higher their risk of dying.
Yet pain ratings told a completely different story, as researchers found no clear link between how much pain patients reported and their chances of survival – challenging assumptions about which symptoms matter most.
Professor Banzett believes the findings make sense when you think about what breathlessness actually signals.
“The sensation of dyspnoea is an alert that the body is not getting enough oxygen in and carbon dioxide out. Failure of this system is an existential threat,” he said.
Medical experts are calling for breathlessness checks to become routine
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He pointed out that while hitting your thumb with a hammer might score eleven out of 10 for pain, it won’t kill you.
Breathing failure is different – it’s the body’s way of screaming that something’s seriously wrong.
Medical experts are calling for this simple breathlessness check to become routine.
Professor Hilary Pinnock from Edinburgh University described it as a “powerful alarm” that could improve patient care, whilst GP Dr Cláudia Almeida Vicente stressed the need for closer monitoring of breathless patients after discharge.
