TY  - BOOK
AU  - Shorr, Andrew F
TI  - Severe acute hypertension among inpatients admitted from the emergency department
SN  - 1553-5592
PY  - 2012///
KW  - *Emergency Service, Hospital
KW  - *Hypertension/ep [Epidemiology]
KW  - *Inpatients
KW  - Acute Disease
KW  - Aged, 80 and over
KW  - Aged
KW  - Female
KW  - Humans
KW  - Length of Stay
KW  - Male
KW  - Medical Audit
KW  - Middle Aged
KW  - Patient Admission
KW  - Prevalence
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - United States/ep [Epidemiology]
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
KW  - Journal Article
KW  - Research Support, Non-U.S. Gov't
N1  - Available in print through MWHC library: 2007 only
N2  - 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
UR  - http://dx.doi.org/10.1002/jhm.969
ER  -