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J Korean Soc Emerg Med > Volume 23(1); 2012 > Article
Journal of The Korean Society of Emergency Medicine 2012;23(1): 78-84.
Emergency Department Based Hypertension Screening Test
Kwang Ho Lee, Soo Hyun Kim, Yeon Young Kyong, Joo Suk Oh, Young Min Oh, Se Min Choi, Kyung Ho Choi, Seung Pill Choi, Kyu Nam Park
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. csm7252@catholic.ac.kr
To identify a useful screening test leading to diagnosis of hypertension in the emergency department (ED).
This was a retrospective medical record review of adult patients (18> or =years of age) admitted to the ED at a tertiary care educational hospital, between January 1, 2010 and February 28, 2010. Only those patients with a triage systolic blood pressure greater than or equal to 140 mmHg, or a diastolic blood pressure greater than or equal to 90 mmHg, were enrolled. Data including baseline characteristics, basic metabolic panel (BMP), urinalysis, electrocardiogram (ECG), chest radiograph, and whether or not they were diagnosed with hypertension, were obtained. Multivariate analysis was performed to determine an appropriate screening test for diagnosis of hypertension.
Of the 447 enrolled patients, 81(18.1%) were diagnosed with hypertension. Age above 35 years (Odds ratio [OR]=8.263; 95% Confidence interval (CI), 1.034-66.062; p=0.046), diagnosis of diabetes mellitus (DM) (OR=3.99; 95% CI, 1.582-10.064; p=0.003), left ventricular hypertrophy (LVH) (OR=4.348; 95% CI, 1.968-9.607; p<0.001), and suspected stage II hypertension (OR=2.699; 95% CI, 1.151-6.329; p=0.022) were independently associated with a positive hypertension diagnosis. The area under the Receiver operating characteristic (ROC) curve for a positive diagnosis of hypertension was 0.687(95% CI, 0.642-0.730).
Age above 35 years, existence of DM or LVH, and suspected stage II hypertension may be useful data points for screening and diagnosis of hypertension in the ED.
Key words: Hypertension, Emergency department, Screening
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