[PP.19.16] HYPERTENSIVE EMERGENCIES AND CRISIS IN AN EMERGENCY DEPARTMENT: EVALUATION AND MORTALITY IN 9 MONTHS

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Abstract

Objective:

Evaluation of the prevalence and severity of hypertensive emergencies and crisis in a Hospital Emergency Service and Follow up of 9 months of hospitalized emergencies

Design and method:

This retrospective study was conducted in the Emergency Department between january 1 and june 30, 2015. All patients with BP> 180 and / or 110 mmHg was recorded and classified in true emergencies (presence of visceral pain) and hypertensive isolated crisis. A phone follow up patients was organized

Results:

During this period, 287 patients (mean age 72 +/− 16, women: 50%) were identified: 136 (49 %) hypertensive crisis and 151 (47 %) hypertensive emergencies: 61 Acute Pulmonary Oedema (APO) (40 %), 31 ischemic stroke (21 %), 27 hemorrhagic stroke (18 %) 11 angina (7 %), 11 myocardial infarction (7%) and 10 differently.

Results:

The clinical characteristics of hypertensive emergencies are preferentially motor deficit (28%), dyspnea (31%), chest pain (16%). The BP of hypertensive emergencies at their admission (3 measurements, oscillometric automatic device) is close to the hypertensive crisis (198+/− 19 - 100 +/− 22 mmHg versus 196 +/− 29 - 98 +/− 21). The BP controlled after 15 minutes of rest is lower for crisis compared to emergencies (166 +/−27 - 86 +/ 20 vs. 173 +/− 26 - 86 +/− 24).

Results:

A phone follow-up was performed after an average period of 9 months on 127 patients: 74 general practitioners of patients who were admitted for a hypertensive emergency, and 53 for hypertensive crisis were contacted . 37 deaths have been recorded, including:14 hospital deaths among hypertensive emergencies and 17 (5 in hemorrhagic stroke group, 4 for ischemic stroke, and 8 for APO) within 9 months in patients hospitalized with hypertensive emergency (total mortality : 31/88: 35 %) and 3 for crisis.

Results:

A questionnaire was sent to physicians who have not answered the phone contacts.

Conclusions:

Hypertensive Emergencies represent 53% of patients hospitalized for Hypertensive urgencies. Their gravity is major because 1/3 of the patients die within 9 months.

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