Survival in Patients With Activity-Related Dyspnea: A Retrospective Cohort Study
- 1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- 2Faculty of Medicine, University of Zurich, Zurich, Switzerland
- 3Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
Abstract
Introduction: In an aging and multimorbid population, activity-related dyspnea is frequent. The aim was to study the prognostic relevance of patient-reported dyspnea, independent of the underlying diseases.
Methods: This retrospective cohort study included patients undergoing cardiopulmonary exercise tests for evaluation of activity-related dyspnea who had simultaneous assessment of dyspnea severity by the New York Heart Association (NYHA) functional class (I–III) or the modified Medical Research Council (mMRC) scale (0–3), which was harmonized into a unified dyspnea severity score (1: NYHA I and/or mMRC 0; 2: NYHA II and/or mMRC 1; 3: NYHA III and/or mMRC 2–3) for analysis. Survival analysis (Kaplan-Meier analysis, Cox proportional hazards model) was adjusted for age, sex, smoking status, exercise-induced desaturation, and number of cardiac and/or pulmonary diagnoses.
Results: A total of 1,061 patients (56% female, 58 years, BMI: 26.3 kg/m2) were included of whom 48% had ≥2 cardiac/pulmonary diseases. The 1-/3-/5-year survival for dyspnea score was 1 99/96/94%, for dyspnea score was 2 98/93/89%, and for dyspnea score was 3 95/87/79% (p < 0.001 for overall group comparisons). Increasing age and male sex were independently associated with worse survival, while exercise desaturation, smoking status, and the number of cardiac/pulmonary diagnoses were not. The combination of dyspnea score 3 and exercise-induced desaturation or ≥2 cardiac/pulmonary diagnoses each had a 5-year survival of 73%.
Conclusion: Activity-related dyspnea in cardiac/pulmonary diseases is independently associated with worse survival irrespective of the number of underlying diagnoses. These findings suggest that activity-related dyspnea may serve as a clinically relevant prognostic marker. Further validation in prospective cohorts is required.
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BibTeX
@article{wick2026survival,
title = {{Survival in Patients With Activity-Related Dyspnea: A Retrospective Cohort Study}},
author = {Carmen Wick and Helga Preiss and Michael Furian and Kay von Grünigen and Stéphanie Saxer and Julian Müller and Simon R. Schneider and Malcolm Kohler and Silvia Ulrich and Mona Lichtblau},
journal = {Respiration},
year = {2026},
month = oct,
doi = {10.1159/res/aepag022},
url = {https://doi.org/10.1159/res/aepag022},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Survival in Patients With Activity-Related Dyspnea: A Retrospective Cohort Study
AU - Carmen Wick
AU - Helga Preiss
AU - Michael Furian
AU - Kay von Grünigen
AU - Stéphanie Saxer
AU - Julian Müller
AU - Simon R. Schneider
AU - Malcolm Kohler
AU - Silvia Ulrich
AU - Mona Lichtblau
PY - 2026
DA - 2026/10/08
JO - Respiration
DO - 10.1159/res/aepag022
UR - https://doi.org/10.1159/res/aepag022
AB - Introduction: In an aging and multimorbid population, activity-related dyspnea is frequent. The aim was to study the prognostic relevance of patient-reported dyspnea, independent of the underlying diseases. Methods: This retrospective cohort study included patients undergoing cardiopulmonary exercise tests for evaluation of activity-related dyspnea who had simultaneous assessment of dyspnea severity by the New York Heart Association (NYHA) functional class (I–III) or the modified Medical Research Council (mMRC) scale (0–3), which was harmonized into a unified dyspnea severity score (1: NYHA I and/or mMRC 0; 2: NYHA II and/or mMRC 1; 3: NYHA III and/or mMRC 2–3) for analysis. Survival analysis (Kaplan-Meier analysis, Cox proportional hazards model) was adjusted for age, sex, smoking status, exercise-induced desaturation, and number of cardiac and/or pulmonary diagnoses. Results: A total of 1,061 patients (56% female, 58 years, BMI: 26.3 kg/m2) were included of whom 48% had ≥2 cardiac/pulmonary diseases. The 1-/3-/5-year survival for dyspnea score was 1 99/96/94%, for dyspnea score was 2 98/93/89%, and for dyspnea score was 3 95/87/79% (p < 0.001 for overall group comparisons). Increasing age and male sex were independently associated with worse survival, while exercise desaturation, smoking status, and the number of cardiac/pulmonary diagnoses were not. The combination of dyspnea score 3 and exercise-induced desaturation or ≥2 cardiac/pulmonary diagnoses each had a 5-year survival of 73%. Conclusion: Activity-related dyspnea in cardiac/pulmonary diseases is independently associated with worse survival irrespective of the number of underlying diagnoses. These findings suggest that activity-related dyspnea may serve as a clinically relevant prognostic marker. Further validation in prospective cohorts is required.
SN - 0025-7931
SN - 1423-0356
ER -