Emergency Department Patients With Acute Severe Hypertension: A Comparison of Those Admitted Versus Discharged in Studying the Treatment of Acute Hypertension Registry

Objectives:To compare the characteristics, treatments, and outcomes for emergency department (ED) patients with severe hypertension by disposition (admitted versus discharged home). 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. 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 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.
Source: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine - Category: Cardiology Tags: Original Articles Source Type: research