Guiga H, Sarlon-Bartoli G, Silhol F, Radix W, Michelet P, Vaïsse B
Service de cardiologie, CHU La Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
Service de cardiologie, CHU La Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
Ann Cardiol Angeiol (Paris). 2016 Jun;65(3):185-90. doi: 10.1016/j.ancard.2016.04.005. Epub 2016 May 13.
Evaluation of the prevalence and severity of hypertensive emergencies and crisis in an Emergency Service of Timone hospital in Marseille and follow-up of 3 months of hospitalized emergencies.
This study was conducted in the Emergency Department between April 1 and June 30, 2015. All patients with BP>180 and/or 110mmHg was recorded and classified in true emergencies (presence of visceral pain) and hypertensive isolated crisis. A phone follow-up patients was organized.
During this period, 170 patients were identified: 95 (56%) hypertensive crisis and 75 (44%) hypertensive emergencies: 25 OAP (33%), 18 ischemic stroke (24%), 15 hemorrhagic stroke (20%), 9 angina (12%) and 8 different. The clinical characteristics of hypertensive emergencies are preferentially dyspnea (27%) motor deficit (36%), and chest pain (16%). The BP of hypertensive emergencies at their admission (3 measurements, oscillometric automatic device) is close to the hypertensive crisis (198.17±19.3 to 96.4±21.2mmHg versus 191±31.6 to 96.12±21). The BP controlled after 15minutes of rest is lower for crisis compared to real emergencies (152±47 to 79±28 vs. 174±31 to 86±26). Age emergency is larger (77±14 vs. 67±17), the number of slightly larger drug (1.79 versus 1.67±1±1). Telephone follow-up was performed after an average period of three months. Ninety-nine patients were contacted by telephone: 46 patients who were admitted for hypertensive emergency patients and 53 for a push. Eighteen deaths have been recorded, including 15 among hypertensive emergencies (9 in hemorrhagic stroke, 5 for ischemic stroke, and 1 for OAP) with 5-hospital deaths within 48hours after admission and 10 within 3 months in patients hospitalized with hypertensive emergency or 33%. Seventy-seven patients out of 99 had been reviewed by their attending physicians. A questionnaire was sent by mail to patients who have not answered the phone contacts, and responses are pending.
Hypertensive emergencies hospitalized in Timone Hospital represent 44% of patients hospitalized for emergency HTA. Their gravity is 1/3 since most patients die within three months warranting closer management of these fragile patients by creating a specialized consulting postemergency.
评估马赛蒂莫内医院急诊科高血压急症和危象的患病率及严重程度，并对住院急症患者进行3个月的随访。
本研究于2015年4月1日至6月30日在急诊科进行。记录所有血压>180和/或110mmHg的患者，并将其分为真正的急症（存在内脏疼痛）和高血压孤立危象。组织了对患者的电话随访。
在此期间，共识别出170例患者：95例（56%）为高血压危象，75例（44%）为高血压急症：25例老年患者（33%）、18例缺血性卒中（24%）、15例出血性卒中（20%）、9例心绞痛（12%）以及8例其他情况。高血压急症的临床特征以呼吸困难（27%）、运动功能障碍（36%）和胸痛（16%）为主。高血压急症患者入院时（3次测量，示波自动装置）的血压与高血压危象接近（198.17±19.3至96.4±21.2mmHg，而高血压危象为191±31.6至96.12±21）。休息15分钟后，危象患者的血压控制水平低于真正的急症患者（152±47至79±28，而真正的急症患者为174±31至86±26）。急症患者的年龄更大（77±14岁，而高血压危象患者为67±17岁），用药数量略多（1.79种，而高血压危象患者为1.67±1±1种）。平均在三个月后进行电话随访。通过电话联系了99例患者：46例为因高血压急症入院的患者，53例为因其他情况入院的患者。记录到18例死亡，其中15例为高血压急症患者（9例死于出血性卒中，5例死于缺血性卒中，1例死于老年患者），5例为入院后48小时内的医院死亡，10例为高血压急症住院患者在3个月内死亡，即33%。99例患者中有77例已由其主治医生进行了复查。向未接听电话联系的患者邮寄了问卷，目前正在等待回复。
蒂莫内医院住院的高血压急症患者占高血压急症住院患者的44%。其严重性为三分之一，因为大多数患者在三个月内死亡，因此需要通过设立专门的急诊后咨询岗位，对这些脆弱患者进行更密切的管理。
