Severe acute hypertension among inpatients admitted from the emergency department. 

 -  2012 
<br/><br/>Available in print through MWHC library: 2007 only 
<br/><br/> BACKGROUND: Hospitalists often treat patients with severe acute hypertension (AH) presenting to the hospital. Little is known about the epidemiology of this syndrome.  CONCLUSIONS: Severe AH appears common and its prevalence varies by underlying clinical condition. Severe AH is associated with excess in-hospital mortality for patients with nervous system diseases and, for most disease categories, prolongs hospitalization. Copyright  2011 Society of Hospital Medicine.  DESIGN: A cohort study using retrospectively collected vital signs and other clinical data.  MEASUREMENTS: Severe AH was defined as at least 1 systolic blood pressure (SBP) >180 mmHg. We used multivariable regression to estimate AH-attributable in-hospital mortality, need for mechanical ventilation (MV), and length of stay (LOS).  OBJECTIVE: To examine the prevalence of severe AH in patients admitted through the emergency department (ED) and its associated outcomes.  PATIENTS: A total of 1,290,804 adults admitted between 2005 and 2007.  RESULTS: Severe AH occurred in 178,131 (13.8%) patients. Disease categories with the highest prevalence were nervous (29.0%), circulatory (16.0%), endocrine (14.7%), and kidney/urinary (13.5%). The overall in-hospital mortality was 3.6%. The relationship between severe AH strata and mortality was graded for nervous system diseases; mortality rates for each 10 mmHg increase in SBP from 180 to >220 mmHg were 6.5%, 8.1%, 9.9%, 12.0%, and 19.7%, respectively (P < 0.0001). The relationship between severe AH strata and need for MV was graded in the most pronounced way in respiratory and circulatory conditions (P < 0.0001). The relationship between severe AH strata and LOS was graded in most disease categories (P < 0.0001).  SETTING: One hundred fourteen acute-care hospitals. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1553-5592 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Emergency Service, Hospital<br/>*Hypertension/ep [Epidemiology]<br/>*Inpatients<br/>Acute Disease<br/>Aged, 80 and over<br/>Aged<br/>Female<br/>Humans<br/>Length of Stay<br/>Male<br/>Medical Audit<br/>Middle Aged<br/>Patient Admission<br/>Prevalence<br/>Retrospective Studies<br/>Severity of Illness Index<br/>United States/ep [Epidemiology]
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Medicine/Pulmonary-Critical Care
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Research Support, Non-U.S. Gov't