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Elevated blood pressure in emergency department patients in Hong Kong: prevalence, characteristics and disposition [Abstract]

Graham, C. A., Chan, S. S., Ahmad, I. and Rainer, Timothy 2012. Elevated blood pressure in emergency department patients in Hong Kong: prevalence, characteristics and disposition [Abstract]. Annals of Emergency Medicine 60 (4) , S142-S143. 10.1016/j.annemergmed.2012.06.437

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Study Objectives: To investigate the prevalence, characteristics and disposition of emergency department (ED) patients with elevated blood pressure. Methods: Consecutive ED records over a 7-day period were hand-searched and retrospectively reviewed. All patients with triage-measured systolic blood pressure (BP) 160mm Hg or above, or diastolic BP 100mm Hg or above, were included. The following data were collected for each patient: prior history of hypertension, any previous treatment for elevated BP, patient disposition (admitted or discharged), BP prior to ED discharge, whether there was a referral for outpatient follow-up of hypertension, and could pain or anxiety have been contributing factors. The total ED attendance for the same period was obtained from AEIS (Accident and Emergency Information System) for prevalence estimation. Results: Five hundred thirty-four patients were included, with mean (+/− standard deviation) age 64.8 (+/−17.0) years; 54.9% were female. The total ED attendance over the study period was 2882, thus the prevalence was 18.5% (95% confidence interval [CI] 17.1 to 20.0). 271 (50.7%) patients had no prior history of hypertension. 175 (35.8%) patients were admitted and 359 (64.2%) patients were discharged. Of those discharged, 311 or 86.6% (95% CI 82.5 to 89.8) had an elevated BP >160/100 prior to discharge. Amongst these, 63 or 20.2% (95% CI 16.0 to 25.2) were discharged with an outpatient referral, 13 or 4.1% (95% CI 2.3 to 7.2) were followed up in the ED, and 235 or 75.5% (95% CI 70.3 to 80.1) were discharged without referral or follow-up. Of these patients who were discharged without referral or follow-up, 170, or 72.3% (95% CI 66.0 to 77.8) did not have pain or anxiety to potentially account for their elevated BP. Conclusions: In the ED setting in Hong Kong, as many as 75% of patients who were discharged with an elevated BP (>160/100) had no referral or follow-up. This may have major public health and primary care consequences for the future.

Item Type: Article
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Additional Information: ACEP Research Forum 2012
Publisher: Elsevier
ISSN: 0196-0644
Last Modified: 04 Jun 2017 09:15

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