Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study: Rationale, design and analysis

Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study: Rationale, design and analysis

Anne-Maree KELLY,1,2 Gerben KEIJZERS,3,4,5 Sharon KLIM,1 Colin A GRAHAM,6 Simon CRAIG,7,8,9, Win Sen KUAN,10,11 Peter JONES,12 Anna HOLDGATE,13,14 Charles LAWOKO,15 Said LARIBI16 and AANZDEM Study Group. Emergency Medicine Australasia (2015) 27, 187–191

Source : 1Joseph Epstein Centre for Emergency Medicine Research @ Western Health, Sunshine Hospital, Melbourne, Victoria, Australia, 2Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia, 3Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia, 4School of Medicine, Bond University, Gold Coast, Queensland, Australia, 5School of Medicine, Griffith University, Gold Coast, Queensland, Australia, 6Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, 7Emergency Department, Monash Medical Centre, Melbourne, Victoria, Australia, 8School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia, 9Murdoch Children’s Research Institute, Melbourne, Victoria, Australia, 10Emergency Medicine Department, National University Health System, Singapore, 11Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 12Department of Emergency Medicine, Auckland City Hospital, Auckland, New Zealand, 13Department of Emergency Medicine, Liverpool Hospital, Sydney, New South Wales, Australia, 14University of New South Wales (Southwest Clinical School), Sydney, New South Wales, Australia, 15Statistical Consulting Service, Victoria University, Melbourne, Victoria, Australia, and 16Department of Emergency Medicine, Saint Louis Lariboisiere Hospitals, Paris, France.

Abstract : Objectives: Shortness of breath is a common reason for ED attendance. This international study aims to describe the  epidemiology of dyspnoea presenting to EDs in the South East Asia-Pacific region, to compare disease patterns across regions, to understand how conditions are investigated and treated, and to assess quality of care. Methods/Design: This is a prospective, interrupted time series cohort study conducted in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of consecutive adult patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72 h periods in May, August and October 2014 (autumn, winter and spring), and included demographics, comorbidities, mode of arrival, usual medications, pre-hospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome and final hospital diagnosis. The primary outcomes of interest are the epidemiology and outcome of patients presenting to ED with dyspnoea. Secondary outcomes of interest are seasonal and geographic comparisons of diagnoses and outcomes, disease-specific descriptions of epidemiology, investigation, treatment and disposition, and compliance with treatment guidelines. Discussion: This novel study will explore dyspnoea from the viewpoint of the patient’s symptom (shortness of breath) rather than that of a single disease. The results will provide robust data about the epidemiology, investigation, treatment and disposition of this diverse patient group. The obtained data also have the potential to inform service planning and to quantify the proportion of patients with mixed cardiac and respiratory disease.