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Prevalence of dyspnea in general adult populations: A systematic review and meta-analysis - 31/10/23

Doi : 10.1016/j.rmed.2023.107379 
Alexander Müller a, b, , Tobias Mraz a, c, Emiel FM. Wouters a, Sander MJ. van Kuijk d, André FS. Amaral e, f, Robab Breyer-Kohansal a, g, Marie-Kathrin Breyer a, c, Sylvia Hartl a, Daisy JA. Janssen h, i
a Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria 
b Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands 
c Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna Healthcare Group, Sanatoriumstrasse 2, 1140, Vienna, Austria 
d Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Peter Debyeplein 1, 6229 HA, Maastricht, the Netherlands 
e National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK 
f NIHR Imperial Biomedical Research Centre, The Bays, Entrance 2, South Wharf Road, St. Mary's Hospital, London, W2 1NY, UK 
g Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Wolkersbergenstrasse 1, 1130, Vienna, Austria 
h Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands 
i Department of Research & Development, Ciro, Hornerheide 1, 6085 NM, Horn, the Netherlands 

Corresponding author. Ludwig Boltzmann Institute for Lung Health, Sanatoriumstrasse 2, 1140, Vienna, Austria.Ludwig Boltzmann Institute for Lung HealthSanatoriumstrasse 2Vienna1140Austria

Abstract

Introduction

Dyspnea is a commonly described symptom in various chronic and acute conditions. Despite its frequency, relatively little is known about the prevalence and assessment of dyspnea in general populations. The aims of this review were: 1) to estimate the prevalence of dyspnea in general adult populations; 2) to identify associated factors; and 3) to identify used methods for dyspnea assessment.

Methods

A systematic literature search was conducted using MEDLINE/PubMed, Embase, CINAHL and JAMA network. Records were screened by two independent reviewers and quality was assessed by using the Joanna Briggs Institute checklist for risk of bias in prevalence studies. Multi-level meta-analysis was performed to estimate pooled prevalence. The protocol was registered on PROSPERO (CRD42021275499).

Results

Twenty original articles, all from studies in high-income countries, met the criteria for inclusion. Overall, their quality was good. Pooled prevalence of dyspnea in general adult populations based on 11 studies was 10% (95% CI 7, 15), but heterogeneity across studies was high. The most frequently reported risk factors were increasing age, female sex, higher BMI and respiratory or cardiac disease. The MRC or the modified MRC scale was the most used tool to assess dyspnea in general populations.

Conclusions

Dyspnea is a common symptom in adults in high-income countries. However, the high heterogeneity across studies and the lack of data from low- and middle-income countries limit the generalizability of our findings. Therefore, more research is needed to unveil the prevalence of dyspnea and its main risk factors in general populations around the world.

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Highlights

Prevalence of dyspnea in general adult populations is 10% [95% CI 7, 15], with substantial variation across studies.
The MRC/mMRC scale is the most frequently used tool for dyspnea assessment in epidemiological studies.
Older age, female sex, impaired lung function, cardiorespiratory disease and high BMI seem to be associated with dyspnea.
There is currently a lack of data on dyspnea prevalence in low- and middle-income countries.

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Keywords : Dyspnea, Breathlessness, Prevalence


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