Clinico‑demographic profile, aetiology, interventions and outcomes of dyspnea presentations in the Emergency Department of a tertiary centre in Nigeria

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Background Dyspnea is a frequent, high-risk emergency complaint with diverse causes and significant resource implications. Delayed presentation and constrained critical care capacity may alter epidemiology and outcomes. We describe the clinico-demographic profile, aetiology, interventions, and outcomes of adult patients with dyspnea in UCH Ibadan ED from 2021–2025. Methods Retrospective descriptive study of adults (≥18 years) with dyspnea documented in ED records between 1 Jan 2021 and 31 Dec 2025. Data were extracted from ED registers and electronic database using a structured proforma. Variables included demographics, referral/arrival mode, symptom duration, triage category, vital signs, diagnoses, interventions, disposition, ED length of stay and mortality. Primary outcomes were dyspnea prevalence among ED visits and in-hospital mortality. Descriptive statistics and chi-square tests for associations were performed; significance set at p<0.05. Results There were 2,623 patients with dyspnea with almost equal sex distribution (49.4% male) and mean age of 51.9±18.4 years. Most were self-referred (76.5%) and only 2.8% arrived via ambulance. Acute dyspnea comprised 73.6%. Patient triaged “red” (TEWS≥7) were 30.7%, and “orange” was 31.0%. Abnormal physiology was common: RR >29/min in 63.0%, SpO2 <90% in 52.0%, and Shock index>0.9 in 36.0%. Leading systemic aetiologies were metabolic/haematological (30.5%), cardiovascular (26.6%) and pulmonary (26.2%). Oxygen therapy was administered commonly (non-rebreather 74%, nasal oxygen 48%); NIV 3.5%, intubation 1.0%. Ward admission 70.8%, critical care 5.4%, and death 11.4%. Mean ED stay was 16.1 hours. Dyspnea category, systemic aetiology, triage code and symptom duration were all significantly associated with mortality and disposition (all p<0.001); red triage and longer symptom duration linked to higher mortality. Conclusion Dyspnea is a common, high-risk presentation, driven mainly by metabolic, cardiovascular and pulmonary conditions, with substantial admission and mortality rates. High prevalence of abnormal physiology and prolonged ED stays highlight needs for strengthened triage, oxygen/ventilatory pathways, timely diagnostics and improved prehospital/critical care access to reduce adverse outcomes.