Document Detail


Predictors of 90-day readmission among patients with acute severe hypertension. The cross-sectional observational Studying the Treatment of Acute hyperTension (STAT) study.
MedLine Citation:
PMID:  20826262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute severe hypertension can be a life-threatening emergency. The objective of this study was to describe the frequency of rehospitalization for patients with acute severe hypertension and to identify clinical predictors of 90-day rehospitalization. METHODS: In this observational cross-sectional study, consecutive patients were identified retrospectively (January 2007 to April 2008) through uniform data query of hospital pharmacy databases in 25 hospitals in the United States. Eligible patients were > or =18 years old, had systolic blood pressure >180 mm Hg and/or diastolic blood pressure >110 mm Hg, and had received intravenous antihypertensive therapy within 24 hours of presentation. Data were collected on patient demographics, medical history, laboratory findings, antihypertensive therapies, resource utilization, hospital-associated events, readmission within 90 days of hospital discharge, and death up to 6 months following the index hospitalization. RESULTS: The 90-day readmission rate was 35% (354/1,009) of patients discharged home alive and with known readmission status; 41% (144/354) were readmitted more than once. Of these 354 patients, readmission was for acute severe hypertension in 29% (n = 101). Eighteen (1.9%) patients died between hospital discharge and 90 days. Factors associated with readmission for hypertension included previous hospitalization for acute severe hypertension, history of drug abuse, and presenting with seizures or shortness of breath. Patients with an admitting diagnosis of hypertension were 94% more likely to be readmitted. CONCLUSIONS: More than one third of patients discharged home after hospitalization for severe hypertension were rehospitalized at least once within 90 days, more than one quarter for acute severe hypertension. Further studies are warranted to determine the impact of other variables on readmission rates and clinical outcomes in this population.
Authors:
Joel M Gore; Eric Peterson; Alpesh Amin; Frederick A Anderson; Joseph F Dasta; Phillip D Levy; Brian J O'Neil; Gene Yong Sung; Joseph Varon; Allison Wyman; Christopher B Granger;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  160     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  521-527.e1     Citation Subset:  AIM; IM    
Copyright Information:
2010 Mosby, Inc. All rights reserved.
Affiliation:
University of Massachusetts Medical School, Worcester, 01605, USA. joel.gore@umassmemorial.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / administration & dosage,  therapeutic use
Comorbidity
Cross-Sectional Studies
Female
Humans
Hypertension / drug therapy,  epidemiology*
Infusions, Intravenous
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Readmission / statistics & numerical data*
Recurrence
Risk Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Investigator
Investigator/Affiliation:
Alpesh Amin / ; Joseph F Dasta / ; James Ferguson / ; Joel Gore / ; Christopher B Granger / ; Kurt Kleinschmidt / ; Stephan A Mayer / ; Alan S Multz / ; W Frank Peacock / ; Eric Peterson / ; Charles Pollack / ; Andrew F Shorr / ; Gene Yong Sung / ; Joseph Varon / ; Matthew Weir / ; John Cienki / ; Lala Dunbar / ; John Devlin / ; Deborah Diercks / ; Icilma Fergus / ; James Froehlich / ; Tony Gerlach / ; Marc LaPointe / ; Phillip Levy / ; Chadwick Miller / ; Richard Nowak / ; Brian O'Neil / ; Noleen Ostapkovich / ; Namrata Patil / ; Jon Schrock / ; Adam Singer / ; Brian Tiffnay / ; Joseph Varon /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension.
Next Document:  Regional myocardial blood flow measured by stress multidetector computed tomography as a predictor o...