McNaughton Candace D, Self Wesley H, Zhu Yuwei, Janke Alexander T, Storrow Alan B, Levy Phillip
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Am J Cardiol. 2015 Dec 1;116(11):1717-23. doi: 10.1016/j.amjcard.2015.09.007. Epub 2015 Sep 10.
Hypertension is a common chronic condition, but the burden of emergency department (ED) visits due to hypertension and associated patient and hospital characteristics are not well described. The goals of this study were to (1) establish the burden of hypertension-related ED visits, estimated by the total number, proportion of adult visits, and population-based rate, (2) evaluate for change over time, and (3) identify associated patient and hospital characteristics. The Nationwide Emergency Department Sample from 2006 to 2012 was used to identify hypertension-related ED visits (International Classification of Diseases, Ninth Revision, Clinical Modification codes 401 to 405, inclusive, and 437.2), and this was linked to US Census Bureau July population estimates to determine population-based rates for each study year. Negative binomial regression was performed to determine whether rates of hypertension-related ED visits changed over time. A total of 165,946,807 hypertension-related ED visits occurred during the 7-year study period (23.6% of all adult ED visits), and hypertension was the primary diagnosis for 6,399,088 (0.9% of all adult ED visits). The estimated yearly incidence rate increased 5.2% per year (incident rate ratio, 1.052; 95% confidence interval, 1.044 to 1.061; p <0.001) for hypertension-related visits and 4.4% per year (incidence rate ratio, 1.044; 95% confidence interval, 1.038 to 1.051; p <0.001) for ED visits with a primary diagnosis of hypertension. Over the same time, the proportion hospitalized decreased and the proportion of visits increased at safety net hospitals and among uninsured patients. In conclusion, these data indicate that hypertension-related ED visits are common and increasing.
高血压是一种常见的慢性病,但因高血压导致的急诊科就诊负担以及相关的患者和医院特征尚未得到充分描述。本研究的目的是:(1)确定高血压相关急诊科就诊的负担,通过就诊总数、成人就诊比例和基于人群的发病率来估计;(2)评估随时间的变化;(3)确定相关的患者和医院特征。使用2006年至2012年的全国急诊科样本确定高血压相关的急诊科就诊(《国际疾病分类,第九版,临床修订本》编码401至405,包括437.2),并将其与美国人口普查局7月的人口估计数相关联,以确定每个研究年份基于人群的发病率。进行负二项回归以确定高血压相关急诊科就诊率是否随时间变化。在7年的研究期间,共发生了165946807次高血压相关的急诊科就诊(占所有成人急诊科就诊的23.6%),高血压是6399088次就诊的主要诊断(占所有成人急诊科就诊的0.9%)。高血压相关就诊的估计年发病率每年增加5.2%(发病率比,1.052;95%置信区间,1.044至1.061;p<0.001),以高血压为主要诊断的急诊科就诊每年增加4.4%(发病率比,1.044;95%置信区间,1.038至1.051;p<0.001)。在同一时期,安全网医院和未参保患者中住院比例下降,就诊比例上升。总之,这些数据表明,高血压相关的急诊科就诊很常见且呈上升趋势。