Background

Understanding the impact of exertion limited by breathlessness on hospital inpatient length of stay (LoS) will complement data showing associations between breathlessness and health service utilisation. In primary care, breathlessness is associated with greater likelihood of referral to the emergency department (ED). Breathlessness on arrival to ED is associated with poorer prognosis.

Aim

To describe the association between exertion limited by breathlessness, measured by the Medical Research Council (MRC) breathlessness scale, and subsequent hospital admission LoS due to any cause.  

Method

A retrospective cohort study in adults with a first-recorded code for breathlessness using MRC codes between 2007 and 2017 with no documented underlying cardiorespiratory disease were included from the UK Clinical Practice Research Datalink (CPRD) primary care database. Breathlessness was measured in routine consultations, not knowing if or when the person may subsequently be admitted to hospital. Associations were investigated between age, sex, BMI, deprivation, comorbidities and MRC grade with LoS in the first subsequent hospital length of stay.   

Results

12,250 adults with MRC recorded had median 844 [IQR 313-1641] days before their first subsequent hospital admission. Linear regression identified a statistically significant association between MRC scores ?3 and increased hospital inpatient LoS (p<0.001, adj R2=0.0155) adjusting for age, sex and deprivation.

Conclusion

This study is the first to identify an association between longer inpatient hospital LoS and increasing MRC score.