{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:29:38Z","timestamp":1791581378661,"version":"4.3.4"},"reference-count":24,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,6,26]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>\n                      Breathlessness is associated with higher rates of unplanned health service utilisation. We aimed to evaluate any associations between the severity of\n                      <jats:italic>breathlessness limiting exertion<\/jats:italic>\n                      (hereafter\n                      <jats:italic>breathlessness<\/jats:italic>\n                      ), time between\n                      <jats:italic>breathlessness<\/jats:italic>\n                      recording and subsequent unplanned hospital admissions, and length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study of adults seen in general practice (UK Clinical Practice Research Datalink) with\n                      <jats:italic>breathlessness<\/jats:italic>\n                      (Medical Research Council (MRC) breathlessness scale; 1\u20135; 5 is most intense), no pre-existing cardio-respiratory disease and a subsequent unplanned hospital admission. Data from 2007 to 2017 were used. By intensity of\n                      <jats:italic>breathlessness<\/jats:italic>\n                      , time to first unplanned admission and hospital length of stay were evaluated, the latter using negative binomial regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      103\u2009917 adults had breathlessness scores recorded, of which 16\u2009948 used MRC. 11\u2009911 (70%) adults had a subsequent unplanned hospital admission (median (IQR) of 1538\u2009days (846\u20132258)) later. More intense\n                      <jats:italic>breathlessness<\/jats:italic>\n                      was associated with higher age, higher body mass index and being a smoker\/ex-smoker.\n                    <\/jats:p>\n                    <jats:p>\n                      Length of time between a first-recorded\n                      <jats:italic>breathlessness<\/jats:italic>\n                      score and the first unplanned hospital admission decreased significantly with higher MRC scores (MRC 1: 1167 days; MRC 5: 615 days).\n                    <\/jats:p>\n                    <jats:p>Negative binomial regression showed an association between higher MRC scores and an increased length of inpatient stay (p&lt;0.001; Akaike information criterion=20\u2009817), controlling for key demographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This is the first study to identify an association between recording\n                      <jats:italic>breathlessness<\/jats:italic>\n                      intensity and time to a person\u2019s first unplanned hospital admission and longer inpatient length of stay. Future work must focus on whether interventions can change people\u2019s health service use.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2024-003000","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:15:17Z","timestamp":1753866917000},"page":"e003000","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Breathlessness intensity recorded in general practice is associated with shorter times to unplanned hospital admissions and longer lengths of stay: a UK cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2376-5028","authenticated-orcid":false,"given":"Urvee","family":"Karsanji","sequence":"first","affiliation":[{"name":"NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4494-2254","authenticated-orcid":false,"given":"Vanessa N","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire A","family":"Lawson","sequence":"additional","affiliation":[{"name":"NIHR Leicester Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9978-2011","authenticated-orcid":false,"given":"Alex","family":"Bottle","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-5113","authenticated-orcid":false,"given":"Magnus","family":"Ekstr\u00f6m","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Kinchin","sequence":"additional","affiliation":[{"name":"Centre for Health Policy and Management, Trinity College Dublin, University of Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3531-0389","authenticated-orcid":false,"given":"Slavica","family":"Kochovska","sequence":"additional","affiliation":[{"name":"IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer K","family":"Quint","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C","family":"Steiner","sequence":"additional","affiliation":[{"name":"NIHR Leicester Biomedical Research Centre - 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