TY - JOUR
T1 - Predictors of 90-day readmission among patients with acute severe hypertension. the cross-sectional observational Studying the Treatment of Acute hyperTension (STAT) study
AU - Gore, Joel M.
AU - Peterson, Eric
AU - Amin, Alpesh
AU - Anderson, Frederick A.
AU - Dasta, Joseph F.
AU - Levy, Phillip D.
AU - O'Neil, Brian J.
AU - Sung, Gene Yong
AU - Varon, Joseph
AU - Wyman, Allison
AU - Granger, Christopher B.
N1 - Funding Information:
Dr Peterson: research grant support from Bristol-Myers Squibb-Sanofi, Schering Plough, and the Merck-Schering Partnership. Dr Amin: no disclosures. Dr Anderson: research grants from The Medicines Company. Dr Dasta: speakers' bureau for Hospira; consultant/advisory board member for Cadence Pharmaceuticals, The Medicines Company, VISICU, Keimar, and Abbott Point of Care. Dr Levy: research grants/other research support from Robert Wood Johnson Foundation Physician Faculty Scholars Program (PI); The Blue Cross Blue Shield of Michigan Foundation; The Cleveland Clinic Foundation; Astellas Pharma US, Inc; Solvay Pharmaceuticals; Nile Therapeutics, Inc; Biosite, Inc; Cardiodynamics, Inc; and Inovise Medical; consultant for The Medicines Company. Dr O'Neil: research grant from The Medicines Company; Consultant/Advisory Board member for Zoll Circulation, BMS, and GSK. Dr Sung: consultant/advisory board member for The Medicines Company; speakers' bureau for Boehringer Ingelheim and EKR Therapeutics. Dr Varon: research grant support from The Medicines Company; speakers' bureau for PDL Biopharma and The Medicines Company; and consultant/advisory board member for The Medicines Company. Allison Wyman: no disclosures. Dr Granger: research grant support and honoraria from, and is a consultant/advisory board member for, The Medicines Company.
PY - 2010/9
Y1 - 2010/9
N2 - 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 ≥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.
AB - 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 ≥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.
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U2 - 10.1016/j.ahj.2010.06.032
DO - 10.1016/j.ahj.2010.06.032
M3 - Article
C2 - 20826262
AN - SCOPUS:77956376046
SN - 0002-8703
VL - 160
SP - 521-527.e1
JO - American Heart Journal
JF - American Heart Journal
IS - 3
ER -