Study Links Breathlessness to Increased Long-Term Mortality in Malawi

A comprehensive study conducted by researchers from the Liverpool School of Tropical Medicine and the Malawi-Liverpool-Wellcome Program has highlighted the significant impact of breathlessness on long-term mortality among hospital patients in Malawi. The investigation revealed that over half of the patients experiencing breathlessness (51%) died within one year of admission, compared to only 26% of patients without this symptom. The study involved tracking 751 patients over a year, with 44% exhibiting breathlessness as a symptom upon hospital entry.

Most of these patients suffered from multiple health conditions contributing to their breathlessness, including pneumonia, anemia, heart failure, and tuberculosis (TB). Notably, the presence of multiple concurrent illnesses was associated with higher mortality, with 69% of patients with heart failure, 57% with anemia, 53% with pneumonia, and 47% with TB dying within a year. In addition, 63% of patients had more than one health issue, emphasizing the complex health profiles of this population.

The findings underscore the importance of adopting integrated, patient-centered care approaches. Health experts argue that treating individual diseases in isolation is insufficient, especially in low-income settings where multimorbidity is common. The research advocates for holistic healthcare strategies capable of diagnosing and managing multiple conditions simultaneously to reduce mortality rates.

Lead researcher Dr. Stephen Spencer emphasized that although oxygen therapy has improved due to COVID-19 responses, mortality among breathless patients in Malawi remains alarmingly high compared to Europe. He pointed out that most patients with breathlessness have more than one underlying health issue, such as TB or pneumonia, which significantly influences outcomes. This highlights the need for health systems in resource-limited environments to increase capacity for respiratory support, including oxygen availability and skilled diagnostics.

The study's findings call for urgent development of multidisciplinary intervention models that can effectively address multimorbidity in patients presenting with breathlessness. The researchers suggest that such comprehensive healthcare programs could sustainably reduce the high mortality associated with this symptom and improve patient outcomes.

This research was a collaborative effort involving institutions across Malawi, Tanzania, the UK, and beyond, and has been published in the journal Thorax.