TY  - BOOK
AU  - Shorr, Andrew F
TI  - Emergency department patients with acute severe hypertension: a comparison of those admitted versus discharged in studying the treatment of acute hypertension registry
SN  - 1535-2811
PY  - 2014///
KW  - *Antihypertensive Agents/tu [Therapeutic Use]
KW  - *Emergency Service, Hospital/sn [Statistics & Numerical Data]
KW  - *Hypertension/dt [Drug Therapy]
KW  - *Patient Admission/td [Trends]
KW  - *Patient Discharge/td [Trends]
KW  - *Registries
KW  - Acute Disease
KW  - Aged
KW  - Blood Pressure
KW  - Cross-Sectional Studies
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Hypertension/ep [Epidemiology]
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Patient Readmission/td [Trends]
KW  - Prognosis
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - United States/ep [Epidemiology]
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
KW  - Comparative Study
KW  - Journal Article
KW  - Multicenter Study
KW  - Observational Study
KW  - Research Support, Non-U.S. Gov't
N1  - Available online through MWHC library: March 2002 - present
N2  - CONCLUSIONS: ED patients with severe hypertension were more likely to be admitted to the hospital if they were >75 years of age, presented with shortness of breath or altered mental status, or had a creatinine >1.5 mg/dL and were not on hemodialysis; METHODS: Studying the Treatment of Acute hyperTension (STAT) is a multicenter registry of 1566 patients with blood pressure >180/110 mm Hg who were treated with intravenous antihypertensive medications in an ED or intensive care unit. Presenting and in-hospital variables, and postdischarge outcomes for the 1053 patients in the ED subset were compared by disposition; OBJECTIVES: To compare the characteristics, treatments, and outcomes for emergency department (ED) patients with severe hypertension by disposition (admitted versus discharged home); RESULTS: In the multivariable analysis, ED patients were less likely to be discharged if >75 years of age (odds ratio [OR] = 0.3, 95% confidence interval [CI] = 0.1-0.9) or if they had shortness of breath (OR = 0.4, 95% CI = 0.2-0.8) or alteration of mental status (OR = 0.1, 95% CI = 0.02-0.9) on arrival. Nondialysis patients with an admission creatinine concentration >1.5 mg/dL were 80% less likely to be discharged than those <1.5 mg/dL (OR = 0.2, 95% CI = 0.08-0.5). In the bivariate analysis, patients with a decrease in systolic blood pressure of <10% 2 hours after medication administration were more likely to be admitted than those discharged (57% vs. 44%; P = 0.041). Disposition did not correlate with 90-day or 6-month mortality or 30-day readmission. However, admitted patients had a higher 90-day readmission rate (38% vs. 24%; P = 0.038)
UR  - http://dx.doi.org/10.1097/HPC.0000000000000014
ER  -