Tilman Keri, DeLashaw Mini, Lowe Sean, Springer Sandy, Hundley Susan, Counselman Francis L
Department of Emergency Medicine, Eastern Virginia Medical School and Emergency Physicians of Tidewater, Norfolk, VA 23507, USA.
Am J Emerg Med. 2007 Mar;25(3):313-7. doi: 10.1016/j.ajem.2006.09.007.
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.
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.
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.
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.
本研究旨在确定急诊医学（EM）医生是否通过诊断、治疗或转诊来识别急诊科（ED）中无症状血压升高（AEBP）的患者。该研究还评估了基于患者年龄、性别、种族或保险状况在识别AEBP方面是否存在差异。
对2004年4月1日至2004年6月30日期间在一家三级护理教学医院急诊科就诊的所有成年患者进行回顾性病历审查。如果记录的血压为140/90毫米汞柱或更高，则纳入患者。排除标准包括年龄小于18岁或大于89岁、高血压病史、入院、由高血压状态明确界定的病情或血压低于140/90毫米汞柱。
共审查了9805份病历；1574名（16%）患者符合纳入标准。我们研究患者的平均年龄为38±14岁；51%为女性，71.8%为非裔美国人。只有112名AEBP患者（7%）因其血压升高而受到关注（即诊断、治疗、药物处方和/或转诊）。在通过患者年龄、性别、种族或保险状况识别出的AEBP患者与未被急诊科医生识别的患者之间，没有统计学上的显著差异。
急诊科医生仅识别、治疗和/或转诊了一小部分患有AEBP的急诊科患者。在基于患者年龄、性别、种族或保险状况的识别、治疗或转诊方面没有差异。
