Recognizing asymptomatic elevated blood pressure in ED patients: how good (bad) are we?

Abstract Objective This study was conducted to determine if emergency medicine (EM) physicians recognize emergency department (ED) patients with asymptomatic elevated blood pressure (AEBP) by diagnosis, treatment, or referral. The study also evaluated whether differences exist in identification of A...

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Veröffentlicht in:The American journal of emergency medicine 2007-03, Vol.25 (3), p.313-317
Hauptverfasser: Tilman, Keri, MD, DeLashaw, Mini, MD, PhD, Lowe, Sean, MS-II, Springer, Sandy, BS, Hundley, Susan, Counselman, Francis L., MD
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container_issue 3
container_start_page 313
container_title The American journal of emergency medicine
container_volume 25
creator Tilman, Keri, MD
DeLashaw, Mini, MD, PhD
Lowe, Sean, MS-II
Springer, Sandy, BS
Hundley, Susan
Counselman, Francis L., MD
description Abstract Objective This study was conducted to determine if emergency medicine (EM) physicians recognize emergency department (ED) patients with asymptomatic elevated blood pressure (AEBP) by diagnosis, treatment, or referral. The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status. Methods A retrospective chart review of all adult patients presenting to a tertiary care teaching hospital ED between April 1, 2004, and June 30, 2004, was performed. Patients were included if documented blood pressure(s) were 140/90 mm Hg or higher. Exclusion criteria included age younger than 18 years or older than 89 years, history of hypertension, admission, condition clearly defined by a hypertensive state, or blood pressure lower than 140/90 mm Hg. Results A total of 9805 charts were reviewed; 1574 (16%) patients met inclusion criteria. The average age of our study patient was 38 ± 14 years; 51% were women and 71.8% were African American. Only 112 patients with AEBP (7%) received attention for their elevated blood pressure (ie, diagnosis, treatment, medication prescription, and/or referral). There was no statistically significant difference between patients identified with AEBP and those not recognized by ED physicians by patient age, sex, race, or insurance status. Conclusions Emergency department physicians recognize, treat, and/or refer only a small percentage of ED patients with AEBP. No difference in identification, treatment, or referral exists based on patient age, sex, race, or insurance status.
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The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status. Methods A retrospective chart review of all adult patients presenting to a tertiary care teaching hospital ED between April 1, 2004, and June 30, 2004, was performed. Patients were included if documented blood pressure(s) were 140/90 mm Hg or higher. Exclusion criteria included age younger than 18 years or older than 89 years, history of hypertension, admission, condition clearly defined by a hypertensive state, or blood pressure lower than 140/90 mm Hg. Results A total of 9805 charts were reviewed; 1574 (16%) patients met inclusion criteria. The average age of our study patient was 38 ± 14 years; 51% were women and 71.8% were African American. Only 112 patients with AEBP (7%) received attention for their elevated blood pressure (ie, diagnosis, treatment, medication prescription, and/or referral). There was no statistically significant difference between patients identified with AEBP and those not recognized by ED physicians by patient age, sex, race, or insurance status. Conclusions Emergency department physicians recognize, treat, and/or refer only a small percentage of ED patients with AEBP. No difference in identification, treatment, or referral exists based on patient age, sex, race, or insurance status.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2006.09.007</identifier><identifier>PMID: 17349906</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Pressure ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Committees ; Confidence Intervals ; Emergency ; Emergency and intensive respiratory care ; Emergency medical care ; Emergency Service, Hospital - statistics &amp; numerical data ; Female ; Heart attacks ; Humans ; Hypertension ; Hypertension - diagnosis ; Hypertension - drug therapy ; Insurance, Health ; Intensive care medicine ; Male ; Medical sciences ; Middle Aged ; Older people ; Physicians ; Primary care ; Retrospective Studies ; Studies ; Teaching hospitals ; Transfusions. Complications. Transfusion reactions. 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The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status. Methods A retrospective chart review of all adult patients presenting to a tertiary care teaching hospital ED between April 1, 2004, and June 30, 2004, was performed. Patients were included if documented blood pressure(s) were 140/90 mm Hg or higher. Exclusion criteria included age younger than 18 years or older than 89 years, history of hypertension, admission, condition clearly defined by a hypertensive state, or blood pressure lower than 140/90 mm Hg. Results A total of 9805 charts were reviewed; 1574 (16%) patients met inclusion criteria. The average age of our study patient was 38 ± 14 years; 51% were women and 71.8% were African American. Only 112 patients with AEBP (7%) received attention for their elevated blood pressure (ie, diagnosis, treatment, medication prescription, and/or referral). There was no statistically significant difference between patients identified with AEBP and those not recognized by ED physicians by patient age, sex, race, or insurance status. Conclusions Emergency department physicians recognize, treat, and/or refer only a small percentage of ED patients with AEBP. No difference in identification, treatment, or referral exists based on patient age, sex, race, or insurance status.</description><subject>Acute coronary syndromes</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Committees</subject><subject>Confidence Intervals</subject><subject>Emergency</subject><subject>Emergency and intensive respiratory care</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - statistics &amp; numerical data</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Insurance, Health</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Physicians</subject><subject>Primary care</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Teaching hospitals</subject><subject>Transfusions. Complications. Transfusion reactions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Committees</topic><topic>Confidence Intervals</topic><topic>Emergency</topic><topic>Emergency and intensive respiratory care</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - statistics &amp; numerical data</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Insurance, Health</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Physicians</topic><topic>Primary care</topic><topic>Retrospective Studies</topic><topic>Studies</topic><topic>Teaching hospitals</topic><topic>Transfusions. Complications. Transfusion reactions. 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The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status. Methods A retrospective chart review of all adult patients presenting to a tertiary care teaching hospital ED between April 1, 2004, and June 30, 2004, was performed. Patients were included if documented blood pressure(s) were 140/90 mm Hg or higher. Exclusion criteria included age younger than 18 years or older than 89 years, history of hypertension, admission, condition clearly defined by a hypertensive state, or blood pressure lower than 140/90 mm Hg. Results A total of 9805 charts were reviewed; 1574 (16%) patients met inclusion criteria. The average age of our study patient was 38 ± 14 years; 51% were women and 71.8% were African American. Only 112 patients with AEBP (7%) received attention for their elevated blood pressure (ie, diagnosis, treatment, medication prescription, and/or referral). There was no statistically significant difference between patients identified with AEBP and those not recognized by ED physicians by patient age, sex, race, or insurance status. Conclusions Emergency department physicians recognize, treat, and/or refer only a small percentage of ED patients with AEBP. No difference in identification, treatment, or referral exists based on patient age, sex, race, or insurance status.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>17349906</pmid><doi>10.1016/j.ajem.2006.09.007</doi><tpages>5</tpages></addata></record>
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subjects Acute coronary syndromes
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Pressure
Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis
Committees
Confidence Intervals
Emergency
Emergency and intensive respiratory care
Emergency medical care
Emergency Service, Hospital - statistics & numerical data
Female
Heart attacks
Humans
Hypertension
Hypertension - diagnosis
Hypertension - drug therapy
Insurance, Health
Intensive care medicine
Male
Medical sciences
Middle Aged
Older people
Physicians
Primary care
Retrospective Studies
Studies
Teaching hospitals
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
title Recognizing asymptomatic elevated blood pressure in ED patients: how good (bad) are we?
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